Anti-ischaemic and haemodynamic effects of elgodipine, a potent new generation calcium antagonist, in chronic stable angina

The effects of oral elgodipine, a new dihydropyridine calcium antagonist on ischaemia and left ventricular function were assessed by a single blind placebo controlled study in 12 patients with chronic stable angina. Graded treadmill exercise and echocardiography/Doppler were performed before and 90 min after single oral doses of elgodipine of 20 mg, 40 mg and 60 mg, or placebo, given at weekly intervals. Elgodipine significantly increased exercise time by 1.1, 2.0 and 2.4 min, (P < 0.001 in each case) and time to onset of angina by 1.1 (P < 0.01), 1.9 (P < 0.001) and 2.6 min (P < 0.001) with increasing doses of the drug. Angina was abolished in 50% of patients with significant improvement in ST depression at peak exercise (P < 0.001) with the 60 mg dose. Blood pressure fell significantly at rest and peak exercise with a corresponding significant increase in heart rate. Ejection fraction was increased by 7.8% (P < 0.001) and 8.4% (P < 0.001) as was the stroke volume by 9.3 ml (P < 0.001) and 12.5 ml (P < 0.001) at 40 mg and 60 mg respectively. Peak mitral A to E velocity ratio and total peripheral resistance decreased significantly in a dose related linear trend. Only minor side effects were noted and no patient required withdrawal from the study. The results demonstrate that oral elgodipine is a potent anti-ischaemic agent. An improvement in the echocardiographic parameters of left ventricular systolic and diastolic function was also seen.