International Journal of Cardiology, 37 (1992) 101-109 0 1992 Elsevier Science Publishers B.V. All rights reserved 0167-5273/92/$05.00 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQP 101 CARD10 01533 Amlodipine in patients with stable angina pectoris treated with nitrates and beta-blockers. The influence on exercise tolerance, systolic and diastolic functions of the left ventricle Jaroslav Meluzin a, MiloS Stejfa a, Miroslav Novak a, Karel Zeman a, Lenka Spinarovh a, Jaroslav Julinek a, Jiii Toman a and Petr Simek b a First Internal Department, St. Anna Hospital, &no. Czechoslovakia; h Centre of Cardiovascular and Transplant Surgery. St. Anna Hospital, Brno, Czechosloctakia (Received 27 February 1992; revision accepted 1 June 1992) Meluzin J, Stejfa M, Novak M, Zeman K, Spinarova L, Julinek J, Toman J, Simek P. Amlodipine in patients with stable angina pectoris treated with nitrates and beta-blockers. The influence on exercise tolerance, systolic and diastolic functions of the left ventricle. Int J Cardiol 1992;37:101-109. The effects of 5 and 10 mg of amlodipine and of placebo were compared in 21 patients with stable angina pectoris and multivessel coronary artery disease. The blind comparison was performed by means of bicycle ergometry and stress echocardiography using esophageal stimulation of the left heart atrium. All patients subsequently received placebo, amlodipine 5 mg and 10 mg for 2 weeks. In bicycle ergometry both doses of amlodipine in comparison with placebo significantly lowered the ST segment depression in lead V5 and prolonged the time to onset of angina. The exercise duration was significantly prolonged only after 10 ,mg of amlodipine. In stress echocardiography 10 mg of amlodipine significantly improved ejection fraction and reduced wall motion score during stimulation and increased peak velocity of relaxation of left ventricular posterior wall at rest and immediately after stimulation. In the patients with left ventricular end-diastolic pressure I 20 mmHg, amlodipine reduced the ratio of peak transmitral flow velocity in atria1 contraction to that in early diastole (A/E) at rest and shortened deceleration time at rest and immediately after stimulation. Amlodipine in patients with stable angina pectoris significantly improved the exercise tolerance and the function of the left ventricle in a dose-dependent way. Amlodipine was well tolerated. Key words: Amlodipine; Angina pectoris; Exercise testing zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJ Introduction Correspondence to: Dr. J. Mel&n, First Internal Dept., St. Anna Hospital, Pekaiska Street 53, Brno. 656 91, Czechoslo- vakia. Amlodipine is a dihydropyridine calcium an- tagonist characterized as having a slow onset and relatively long duration of action. In patients with