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V I Metelitsa

Publications and source records attributed to V I Metelitsa.

At least 19 recordsLinked to original sources
PubMed1992

Enhancement of the efficacy of isosorbide dinitrate by captopril in stable angina pectoris.

This study was designed to assess whether the angiotensin-converting enzyme inhibitor captopril could potentiate the efficacy of a single dose of oral isosorbide dinitrate (ISDN) in patients with coronary artery disease. Fourteen men (mean age 53 years) with stable angina pectoris were studied. In each patient the efficacy of placebo, captopril (50 to 100 mg), ISDN (10 mg), and a combination of captopril (50 to 100 mg) and ISDN (10 mg) was assessed by repeated exercise treadmill tests performed before and 1, 2, 3 and 6 hours after administration of a single dose. A single-blind, randomized technique was applied. According to the mean data in the whole group of 14 patients, captopril alone produced no improvement in exercise duration to the onset of angina and to angina of moderate severity compared with placebo. The magnitude of ST-segment depression did not significantly change after captopril administration. ISDN alone significantly increased exercise duration to onset of angina and to angina of moderate severity (antianginal effect) and decreased the magnitude of ST-segment depression (antiischemic effect) 1 to 3 hours after administration. Combined administration of ISDN and captopril resulted in more expressed antianginal and antiischemic effects; at 2, 3 and 6 hours these effects with ISDN plus captopril were significantly more pronounced than those with ISDN alone. According to individual data, the most marked potentiation of ISDN efficacy was observed in patients who had poor response to ISDN alone. In all 6 patients in whom ISDN alone was ineffective, after the addition of captopril the desired antianginal effect was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1992

[The efficacy of nitrendipine in patients with stable arterial hypertension. The data from a cooperative study in the USSR. The Working Group for the Cooperative Study of Nitrendipine].

Nitrendipine (bypress) manufactured by Bayer Company in the form of 10 and 20 mg tablets and administered in a dose of 20-40 mg/day turned out an effective antihypertensive remedy in 65% of patients with arterial hypertension largely running a mild course. The effect of nitrendipine administered in a single daily dose of 20 mg did not differ from that attained with the same dose given in two intakes. The raising of the daily dose of nitrendipine from 20 to 40 mg was associated with augmentation of the hypotensive effect in 43.8% of the patients in whom the treatment in a dose of 20 mg a day had turned out ineffective. Under the conditions of the cross-over method with the use of the reference drugs belonging to three groups of the basic antihypertensive agents (nifedipine, propranolol, hydrochlorothiazide), the hypotensive effect of nitrendipine did not differ from that produced by the drugs under comparison (according to the mean group indicators and individual assessment of the efficacy). The tolerance of nitrendipine administered in a dose of 10 mg twice a day or in a dose of 20 mg once or twice a day was satisfactory.

Adult↗
PubMed1992

[A comparison of the efficacy of nitrogranulong and other prolonged-action nitrates by using paired bicycle ergometry in patients with stenocardia].

The efficacy of single doses of nitrogranulong, 5.2 mg, trinitrolong, 2 mg, nitrong 6.5 mg, and placebo was evaluated in 10 males aged 46-62 years who had Functional Classes II-III angina on effort. For this, paired bicycle ergometry was employed. In patients in whom nitrogranulong, 5.2 mg, turned out to be ineffective, the effective dose was evaluated as 10.4 mg. The effect of a drug was evaluated from an increase in exercise duration before the occurrence of a moderate anginal attack and/or 1 mm or more ST-segment depression in bicycle ergometry performed when the maximum effect of the single dose was expected than that in bicycle ergometry performed before achieving the same criteria for exercise discontinuation on the same day before the drug use (delta T threshold). The single dose of a drug was considered to be beneficial at delta T threshold > or = 120 sec (individual effects). Trinitrolong in a dose of 2 mg turned out be the most effective: there was the most mean value of delta T threshold and the individual effect was seen in 100% of the patients. According to the accepted criterion, nitrogranulong, 5.2 mg, and nitrong, 6.5 mg, were effective in 20%. Nitrogranulong, 10.4 mg, was beneficial in more 40% of patients; in all the first and the second doses of the drug were beneficial in 60%.

Angina Pectoris↗
PubMed1991

[A cross-over study of ketanserin compared to placebo, beta-adrenergic blockader, diuretic and alpha 1-adrenergic blockader. Cooperative research in the USSR (the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension). Working Group (4)].

In 51 patients with stage II essential hypertension (mild and moderate arterial hypertension), a cross-over study was carried out to estimate the efficacy of the use of ketanserin (KS), an antagonist of serotonin receptors, as compared to the efficacy of placebo, the beta-adrenoblocker propranolol (PP), the diuretic triampur and the beta 1-adrenoblocker prazosin. When administered in the daily dose 40-80 mg, KS produced an antihypertensive effect in 43.7% of the patients. The efficacy of KS administered once or twice a day did not practically differ. The side effects of the monotherapy were unmarked and required the drug withdrawal only in 2 patients (4%). KS produced no material shifts in the biochemical parameters with the exception of a slight increase of the activity of alanine transferase and led to a certain reduction of carbohydrate tolerance. In patients who responded to KS, the drugs belonging to the other three groups appeared effective as well. Both KS combined with triampur and KS combined with PP provided a higher antihypertensive effect than monotherapy with each of those drugs. The combination of KS and prazosin produced the same effect as monotherapy with prazosin.

Adrenergic alpha-Antagonists↗
PubMed1991

[The ability of captopril to enhance the anti-anginal effect of isosorbide dinitrate in patients with stable exercise-induced angina pectoris].

The interaction between isosorbide dinitrate (ISDN) and the angiotensin-converting enzyme inhibitor captopril was investigated in 14 patients with coronary heart disease concurrent with stable exercise-induced angina pectoris. The efficacy of placebo, ISDN, 10 mg, captopril, 50-100 mg, and ISDN + captopril was evaluated in each patient by pharmacodynamic treadmill studies. The single-blind, randomized technique was applied. Captopril alone produced a weak antianginal effect. The concomitant use of ISDN and captopril showed significantly more marked and prolonged effects than ISDN alone. The highest effect was exhibited by ISDN supplemented with captopril in 6 patients who had been refractory to ISDN alone. Thus, captopril may potentiate the antianginal effect of ISDN.

Angina Pectoris↗
PubMed1991

[Screening of single doses of the main antihypertensive drugs at rest and during various exercise tests in patients with hypertension].

The single doses of three reference antihypertensive drugs: corinfar (20 mg), anapriline (80 mg), and hypothiazide (50 mg) were screened on day 5 of drug administration at rest and during paired isometric and dynamic exercises in comparison to placebo. There was a significant decrease in blood pressures: systolic (SBP), diastolic (DBP), and mean (MBP) (p less than 0.01-0.001) at rest and during isometric and dynamic exercises after single doses of corinfar and hypothiazide versus placebo. A single dose of anapriline resulted in a significant reduction in SBP and MBP at rest and during dynamic exercise (p less than 0.05-0.001), in DBP at rest (p less than 0.05) and in an insignificant decrease in SBP, DBP, and MBP during isometric exercise and DBP during dynamic exercise. The agents were graded in terms of the effect of placebo from the mean group and individual hypotensive effects (by each blood pressure parameter). The resting dynamic exercise failed to yield some new evidence for determining the efficacy of corinfar and hypothiazide, whereas it was informative for anapriline with regard to SBP. With respect to SBP, DBP, and MBP, isometric exercise was informative for hypothiazide.

Adult↗
PubMed1991

[The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped-plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. I. The research protocol and results of monotherapy].

The paper concerns a cooperative open study with participation of 10 centers of the USSR. After receiving placebo 419 men aged 30-59 years suffering from arterial hypertension (diastolic arterial pressure in the sitting position greater than or equal to 95 mm Hg) were given antihypertensive drugs after randomization. The treatment was provided in accordance with a stepped scheme and was started from monotherapy with the beta-adrenoblockers nadolol or propranolol (PP), or with the indirect vasodilator prazosin (PS) or the diuretic. If monotherapy failed, the patients were administered combinations of the indicated drugs. The treatment lasted one year, with a monthly control being exercised. 356 patients completed the studies. Of these, 131 patients (36.8%) had received monotherapy toward the end of the year. During the entire year, monotherapy was provided to 48.9% of the patients who started treatment from nadolol and completed the studies, to 34.1% who started treatment from PP, to 35.5% who started treatment from PS, and only to 14.4% of the patients who started treatment from the diuretic. Comparison of the patients' group given the diuretic with all the remaining groups demonstrate the difference to be significant. By the end of the treatment with nadolol, PP and PS, the diastolic arterial pressure reduced 10-11%, whereas toward the end of monotherapy with the diuretic, it dropped 6%, with the difference being significant. In patients on monotherapy, the negative chronotropic effect of nadolol exceeded that in patients given PP. Nadolol is an effective long-acting beta-blocker. By the intensity of the antihypertensive effect the drug is not inferior to PP or PS and compares very favourably with the diuretic.

Adult↗
PubMed1991

The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped-plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. II. The results of combined therapy. Side effects. The reasons for dropouts. Conclusion.

The efficacy and safety of nadolol (N), propranolol (PP), prazosin (PS) and a diuretic (D) were studied and compared with the aid of a total systems approach in a cooperative open study with participation of 10 centers of the USSR. As many as 419 men suffering from arterial hypertension (diastolic AP 95 mm Hg) were entered into the study. After randomization the patients received one of the 4 drugs. In case the monotherapy failed, combinations of 2-3 drugs were administered. The treatment lasted one year, with a monthly control being exercised. The patients' from the study accounted for 15% including the final points which constituted 1.9%. Of these, 6 patients suffered myocardial infarctions (one with a fatal outcome) and 2 presented with cerebral circulatory disorders. 3.8% of the patients were withdrawn from the study because of the side effects of the drugs. Out of 356 patients who completed the studies, 36.8% received one, 43% two, and 20.2% three drugs by the end of the year. The protocol of the study and the results of the monotherapy were provided in Communication I. Combined therapy with two or three drugs was effective whatever the combination and brought about a 12-16% decrease of diastolic AP. The negative chronotropic effect of N exceeded that of PP. The stable effect, t. e. the effect that lasted continuously over 6 months, was seen in less that half the patients treated for a year. Therefore, N is an effective, comparatively safe and long-acting beta-blocker. As for its efficacy, it does not yield to PP or PS and compares very favourably with D. The drug can successfully be used in long-term treatment of arterial hypertension.

Adult↗
PubMed1991

[Possibilities of potentiating the antianginal action of nitrates by methionine in patients with stable effort angina pectoris].

When given in a single dose, methionine was studied for its effects on the efficacy of isosorbide dinitrate in 8 patients with coronary heart disease. The antianginal and anti-ischemic effects of the agents were evaluated by treadmill exercise testing that had been performed prior to and repeatedly (1, 2, 3, and 6 hours) following a single application of the drug. Methionine in a dose of 1 g failed to produce antianginal and anti-ischemic effects. The concomitant use of isosorbide dinitrate (10 mg) and methionine (1 g) showed significantly pronounced antianginal and anti-ischemic effect than that of isosorbide dinitrate alone. The methionine-induced increase in the effect of isosorbide dinitrate substantially differed in the patients. Thus, methionine is able to potentiate the antianginal and anti-ischemic effect of isosorbide dinitrate.

Angina Pectoris↗
PubMed1991

[Value of isometric and dynamic exercise tests with standard drug doses for selecting long-term antihypertensive treatment with vasodilators, adrenergic beta blockaders and diuretics].

The paper presents the results of the study into the efficacy of single routine doses of essential antihypertensive agents (nifedipine, propranolol, and hydrochlorothiazide) versus its course treatment at rest and during isometric and dynamic exercise tests. The efficacy was assessed by using the Dixon criterion. The routine drug dose tests performed at rest and during isometric and dynamic exercise were shown to have a varying informative value in the prediction of long-term treatment with the above drugs. The isometric and dynamic exercise tests are of the greatest significance in the evaluation of the antihypertensive routine dose of nifedipine, whereas the dynamic exercise test alone is of value for propranolol and the rest exercise test, the both exercise tests for hydrochlorothiazide. Thus, the results of the corresponding routine drug dose tests are of varying predictive informative value, which is essential both for choosing an effective drug and for making an objective assessment of the outcomes of the course therapy.

Adult↗
PubMed1991

[The effect of single doses of antianginal preparations on the correlation of the time of the onset of typical pain and the electrocardiographic signs of myocardial ischemia in patients with stenocardia of effort].

Altogether 359 paired bicycle ergometries coupled with administration of single doses of antianginal drugs were carried out in 62 men suffering from angina pectoris of effort, functional classes II and III. A study was made of the indicator characterizing the time that elapsed since the onset of a typical angina pectoris attack till the appearance of the signs of ischemia on the ECG. Administration of effective single doses of antianginal drugs raised the time elapsed since the pain onset till the appearance of the ST segment greater than or equal to 1.0 mm fall during the exercise. Administration of ineffective doses of nitrates, calcium antagonists and placebo entailed a decline of that indicator, a rise of the number of cases where the segment ST greater than or equal to 1.0 mm fall was recordable before the onset of painful sensations. Administration of propranolol in ineffective single doses failed to provoke a decrease of the time elapsed since the typical pain onset till the appearance of the ST segment greater than or equal to 1.0 mm fall. Intake of ineffective single doses of nitrates, calcium antagonists and placebo may deprive certain patients of early signalization and appearance of the ECG signs of myocardial ischemia.

Angina Pectoris↗
PubMed1991

[Does captopril produce an antianginal effect in patients with stable exercise-induced angina pectoris?].

Captopril (C), isosorbide dinitrate (ID), and nifedipine (N) were evaluated for antianginal effects (AAE) in 12 patients with ischemic heart disease. The effects were assessed by treadmill exercise tests performed before and repeatedly 1, 2, 3, and 6 hours after the single dose of a drug or placebo. C, ID, and N were given in doses of 50, 10, and 20 mg, respectively. The drugs were equally effective in lowering systolic blood pressure at rest. Unlike ID and N, C failed to affect the duration of exercise testing until an anginal episode occurred and the magnitude of ST-segment depression at the same exercise intensity. ID and N caused a significant increase in the duration of exercise and a decrease in ST-segment depression during exercise 1-3 h later. An individual analysis has shown that C, ID, and N produced an antianginal effect only in 2, 9, and 10 patients, respectively. Thus, C is unable to show a substantial antianginal effect.

Adult↗
PubMed1990

Development of tolerance to nifedipine in patients with stable angina pectoris.

1. The possibility of development of tolerance to the anti-ischaemic and anti-anginal effects of nifedipine during sustained administration for 2 months was studied in 15 patients with stable angina pectoris by means of repeated exercise tests on a treadmill. 2. After acute administration of nifedipine (20-30 mg) substantial anti-ischaemic and anti-anginal effects lasted for at least 4 h in all patients. 3. During sustained nifedipine treatment with a dose schedule which provided continuous anti-ischaemic effect during a day (mean daily dose 82.7 +/- 6.0 mg, range 60-120 mg) a substantial attenuation of this effect was registered. The duration of the anti-ischaemic effect was 5.4 +/- 0.3 h after acute administration, decreasing significantly to 3.6 +/- 0.4 h during sustained administration. 4. The attenuation of the nifedipine effect was not associated with worsening of the patients' condition. 5. Plasma concentrations of nifedipine and its metabolite were similar after acute administration and during sustained treatment. Protein binding of nifedipine also remained constant during the study. 6. There was marked interindividual variation in the degree of attenuation of the nifedipine effect during sustained administration. In five patients nearly complete loss of nifedipine efficacy was registered. Eight to ten days after stopping regular administration of nifedipine only partial restoration of nifedipine effect was observed. 7. We conclude that during sustained nifedipine administration tolerance to its anti-ischaemic, anti-anginal and circulatory effects develops in a substantial number of patients with stable angina pectoris.

Angina Pectoris↗
PubMed1990

[The comparative efficacy of nicardipine and nifedipine in stenocardia patients].

Altogether 12 patients with stable angina pectoris of effort were examined for the efficacy of nicardipine as compared to nifedipine and placebo by means of pharmacodynamic studies using treadmill. Nicardipine exerted a significant antianginal and anti-ischemic action 1, 2 and 3 hours after the intake of single dose (40 or 60 mg). The efficacy of nifedipine in a single dose of 20 or 30 mg was more remarkable in spite of the fact that differences in the drug efficacy were not statistically significant. The side effects such as headache, heat sensation and face hyperemia were more frequently recorded after the intake of nicardipine than after the intake of nifedipine. Therefore nicardipine, a new calcium antagonist of the dihydropyridine series, can be applied to the treatment of patients with stable angina pectoris of effort. However, as compared to nifedipine, it has no advantages over it.

Angina Pectoris↗
PubMed1990

[An assessment of the efficacy of a course of using different forms of prolonged-action nitrates in patients with stable stenocardia with the help of repeated daily ECG monitoring].

A study was made of the antianginal and anti-ischemic effects of sustac (ST) and trinitrolong (TNL) during their cross continuous use in patients with stable angina pectoris, functional class II-III (according to the classification of the Canadian Association of Cardiologists). In accordance with the daily ECG monitoring data, the three-month treatment with the effective doses of ST and TNL produced a significant lowering of the frequency and the total intensity of the episodes of ST segment depressions of the ischemic type as compared to the continuous administration of placebo. The use of criteria for evaluating the efficacy of the antianginal drugs (the decrease of the total number of ST segment depression episodes during one day by 3 and over and/or reduction of the total intensity of ST segment depression by 50% and over) made it possible to reveal varying effects of the nitrates on painful episodes (PE) and painless episodes of ST segment depression. Both the dosage forms of nitroglycerin administered in the effective amounts (in short- and long-term continuous treatment) significantly lowered the rate and total intensity of myocardial ischemia episodes at the expense of a significant decrease of the frequency and total intensity of PE. They produced no material effect on the number of painless episodes. Provided ST and TNK turned out ineffective, there was a significant rise of the frequency and total intensity of painless episodes in short-term continuous treatment while ST produced the above effect in long-term treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗