The effect of Alinidine (ST 567) on hemodynamics at rest and during exercise was studied in subjects with angiographically documented coronary artery disease and left ventricular dysfunction. Exercise tests were performed before and 30 min after intravenous administration of 20 mg of Alinidine. Significant decreases were observed for heart rate at rest and during exercise, for systolic and diastolic blood pressure. Pressures in the pulmonary artery and in capillary wedge position were significantly reduced after Alinidine by about 12 to 18% (mean PAP) and by about 19 to 28% (PCW). Cardiac output and stroke volume increased during exercise after Alinidine, but the differences were not significant. Depression of ST-segment in the exercise-ECG was significantly lower after Alinidine, angina pectoris occurred in all but one subject during control testing but in none after Alinidine. It is concluded that Alinidine is an effective antianginal drug. Intravenous administration of this agent even in a low dose improves cardiac performance during exercise in patients with impaired left ventricular function. Negative inotropic effects of Alinidine were not observed in this study. Bradycardia and in addition preload reduction are suggested to be the main mechanisms to improve left ventricular function and symptomatic status.
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