Therapeutic effect of urapidil on myocardial perfusion in patients with ST-elevation acute coronary syndrome.
ABSTRACT To evaluate the effect of urapidil on myocardial perfusion, and ventricular function in patients with ST-elevation acute coronary syndrome (ACS) treated with primary percutaneous coronary intervention (PCI).
Fifty-four patients were randomized into urapidil (12.5 mg, ic, n=27) or control group. Infarct related artery (IRA) was targeted with PCI following urapidil administration. TIMI blood flow, corrected TIMI frame count (cTFC), myocardial blush grade (MBG), ST resolution (STR) on ECG, creatine kinase MB (CK-MB) and cardiac troponin T (cTnT) were measured before, and after PCI.
cTFC (18.38+/-3.30 vs 21.44+/-4.26, P=0.005), in the treatment group was lower than the placebo group, whereas MBG was higher (P=0.04). More patients in the urapidil group achieved significant STR following PCI (93% vs 70%, P=0.04). Left ventricular ejection fraction (LVEF), measured with echocardiography, in the urapidil group was higher than the control group 30 days after PCI (0.58+/-0.06 vs 0.54+/-0.06, P=0.04). Peak CK-MB and peak cTnT in the urapidil group was lower than the control group (P<0.01). Myocardial nitric oxide concentration in the urapidil group was higher than that of the control group (P<0.01). Following PCI, the endothelin-1 level did not change in the urapidil group (P>0.05) but it was increased in the control group (P<0.05).
Urapidil treatment improves coronary flow, myocardial perfusion and left ventricular function following PCI in patients with ST-elevation ACS. These beneficial effects are associated with an enhanced biosynthesis of nitric oxide.
- [Show abstract] [Hide abstract]
ABSTRACT: In this paper we present the test and validation results for the RCS of spherical objects derived by using conformal finite difference time domain (CFDTD) technique, which was introduced for obviating the staircasing errors introduced by the conventional finite difference time domain (FDTD) approach when dealing with curved bodies. We demonstrate that the CFDTD results show significant improvement in accuracy over those derived by using the conventional FDTD that employs a staircasing of the sphere geometryAntennas and Propagation Society International Symposium, 1999. IEEE; 09/1999
Article: Urapidil : revue des études récentes[Show abstract] [Hide abstract]
ABSTRACT: Urapidil is an antihypertensive agent with both central and peripheral effects. It induces an α1-adrenoreceptor blockade responsible for a decrease in peripheral arterial resistances. Urapidil also induces an inhibition of sympathetic tone by a central mechanism of action involving both α1 adrenergic blockade and a serotoninergic agonist activity on 5HT1A receptors. Urapidil does not induce reflex tachycardia and has bronchodilating properties. Since the last review in 1998, several studies have pointed out its effects in various clinical situations: Urapidil can be safely used in hypertensive emergency management in both pre- and postoperative periods such as pheochromocytoma surgery. Urapidil is also adapted to the treatment of hypertension during electroconvulsivotherapy and preeclampsia. Urapidil improves the hemodynamic status and cardiac index in patients with pulmonary arterial hypertension. The lack of vasodilation associated-tachycardia is beneficial to patients with coronary artery disease. Coronary artery flow is increased after angioplasty with urapidil administration, whether it was carried out as an emergency in acute coronary syndrome or scheduled procedure. Finally, urapidil's α1-adrenoreceptor blocking effect may release a neurogenic or obstructive voiding dysfunction.Le Praticien en Anesthésie Réanimation 06/2011; 15(3):180-187. DOI:10.1016/j.pratan.2011.05.001
- [Show abstract] [Hide abstract]
ABSTRACT: Nitric oxide (NO) formed via endothelial NO synthase (eNOS) plays crucial roles in the regulation of coronary blood flow through vasodilatation and decreased vascular resistance, and in inhibition of platelet aggregation and adhesion, leading to the prevention of coronary circulatory failure, thrombosis, and atherosclerosis. Endothelial function is impaired by several pathogenic factors including smoking, chronic alcohol intake, hypercholesterolemia, obesity, hyperglycemia, and hypertension. The mechanisms underlying endothelial dysfunction include reduced NO synthase (NOS) expression and activity, decreased NO bioavailability, and increased production of oxygen radicals and endogenous NOS inhibitors. Atrial fibrillation appears to be a risk factor for endothelial dysfunction. Endothelial dysfunction is an important predictor of coronary artery disease (CAD) in humans. Penile erectile dysfunction, associated with impaired bioavailability of NO produced by eNOS and neuronal NOS, is also considered to be highly predictive of ischemic heart disease. There is evidence suggesting an important role of nitrergic innervation in coronary blood flow regulation. Prophylactic and therapeutic measures to eliminate pathogenic factors inducing endothelial and nitrergic nerve dysfunction would be quite important in preventing the genesis and development of CAD.International Journal of Angiology 09/2011; 20(3):121-34. DOI:10.1055/s-0031-1283220