Browsing by Author "CHAMORRO, G"

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    EFFECT OF A CALCIUM INHIBITOR, NIFEDIPINE, ON EXERCISE TOLERANCE IN PATIENTS WITH ANGINA-PECTORIS - A DOUBLE-BLIND-STUDY
    (1981) CORBALAN, R; GONZALEZ, R; CHAMORRO, G; MUNOZ, M; RODRIGUEZ, JA; CASANEGRA, P
    The effect of nifedipine on exercise tolerance was studied in 30 patients with stable angina and positive graded exercise testing. Treadmill exercise testing was performed on each of 5 consecutive days. Placebo or nifedipine, 10 mg sublingually, was given 30 min before exercise on the 3rd day. The following day the intervention was reversed in a double-blind manner. Angina was abolished by nifedipine but not by placebo in 12 patients (40%). The time to onset of angina in the remaining patients increased from 4.1 .+-. 0.4 (SEM [standard error of mean]) to 6.7 .+-. 0.6 min (P < 0.001). Time to ST depression .gtoreq. 2 mm increased from 4.0 .+-. 0.3 to 5.4 .+-. 0.5 min, while duration of exercise increased from 6.3 .+-. 0.3 to 8.2 .+-. 0.4 min (P < 0.001). The maximum heart rate was 145 .+-. 3.3 with nifedipine and 122 .+-. 3.8 min-1 with placebo (P < 0.01). Resting systolic blood pressure decreased 30 min after nifedipine administration from 131 .+-. 3.4 to 106 .+-. 2.9 mm Hg (P < 0.01). Maximal systolic blood pressure during exercise was lower with nifedipine (127 .+-. 4.8 mm Hg) than with placebo (155 .+-. 8.6 mm Hg, P < 0.01). Nifedipine significantly improves the exercise tolerance of patients with stable angina pectoris by decreasing peripheral vascular resistance and myocardial O2 demand.
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    EFFECTS OF CAPTOPRIL VERSUS MILRINONE THERAPY IN MODULATING THE ADRENERGIC NERVOUS-SYSTEM RESPONSE TO EXERCISE IN CONGESTIVE HEART-FAILURE
    (1990) CORBALAN, R; JALIL, J; CHAMORRO, G; CASANEGRA, P; VALENZUELA, P
    The potential adverse consequences of increased adrenergic nervous system activity in patients with heart failure are now recognized. Modulation of the plasma noradrenaline response to submaximal exercise should be desirable. The long-term (9 weeks) effects of milrinone (10 mg 4 times a day) or captopril (50 mg 3 times a day) compared to placebo were evaluated in a double-blind crossover study, in 16 patients with stable, congestive heart failure receiving digoxin and furosemide. After treatment, clinical status (score range 0 to 14 points) improved significantly with both milrinone (4.4 .+-. 0.5, p < 0.01) and captopril (4.1 .+-. 0.4, p < 0.01). Plasma noradrenaline at rest was similar with both drugs and not significantly different from placebo. During submaximal exercise it increased significantly to 1,295 .+-. 174 pg/ml with milrinone; this response was reduced significantly with captopril, to 820 .+-. 100 pg/ml (p < 0.01). Thus, long-term therapy with both captopril and milrinone improved the clinical score, but only captopril reduced the plasma noradrenaline response to submaximal exercise. These findings suggest that angiotensin-enzyme inhibition with captopril will modulate the adrenergic system response to daily activities in patients with chronic congestive heart failure and therefore could have additional salutary effects beyond vasodilatation.
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    ROLE OF PROGRAMMED ELECTRICAL-STIMULATION OF THE HEART IN RISK STRATIFICATION POST-MYOCARDIAL INFARCTION
    (1988) GONZALEZ, R; ARRIAGADA, D; CORBALAN, R; CHAMORRO, G; FAJURI, A; RODRIGUEZ, JA