Clinical Benefit of a Therapy with OPC-13340, a Calcium Antagonist, on Exercise Hemodynamics in Effort Angina

OPC-13340 is a dihydropyridine derivative calcium antagonist and was demonstrated to have a potent and long-lasting vasodilating effect.The cardiohemodynamic effects of the drug before and during exercise were studied in ten patients with effort angina using a bicycle ergometer.The patients received the drug at 4mg once daily after breakfast for one week. Cardiohemodynamic measurements were performed during exercise before and after administration of the drug.OPC-13340 produced a significant improvement in ST depression and an improvement in subjective symptoms during exercise, significant decreases in systolic blood pressure, diastolic blood pressure and total peripheral resistance before and during exercise, no notable changes in heart rate before and during exercise, a significant increase in cardiac index during exercise with an insignificant change before exercise, a significant decrease in systolic, diastolic and mean pulmonary arterial pressures during exercise with insignificant changes before exercise, a significant increase in left ventricular ejection fraction (EF) before and during exercise and a significant suppression of decreased EF due to exercise load.These results indicated that OPC-13340 has major hemodynamic effects featured by a decrease in afterload due to dilation of peripheral arteries and an anti-anginal effect due to coronary vasodilation. In addition, manifestation of an improvement in the EF during exercise suggests that the drug exerts an anti-anginal effect without decreasing cardiac function.Thus, OPC-13340 produced electrocardiographic and hemodynamic improvements during exercise in effort angina patients and was therefore believed to be a useful drug in the treatment of ischemic heart diseases.