Abstract
The effects of perhexiline on symptomatic and hemodynamic responses to exercise stress were evaluated in 16 patients with coronary artery disease and angina pectoris. Exercise-induced angina was prevented (12 of 16) or delayed during perhexiline treatment and exercise heart rate decreased (117.4 ± 6.1 [standard error of the mean] to 105.3 ± 3.6 beats/min, P < 0.05). Ischemia-related indexes of left ventricular dysfunction were attenuated (stroke work index 70.9 ± 5.7 to 86.4 ± 5.3 g-m/beat per m 2 and filling pressure 26.4 ± 3.0 to 17.7 ± 2.5 mm Hg, P < 0.01) without evidence for depression of other indexes of ventricular function. Additionally, the exercise diastolic pressuretime index increased 36.5 ( P < 0.01) and the diastolic pressure-time/ tension-time ratio increased 38 percent ( P < 0.05) with perhexiline in the patients who were free of angina. During increased exercise stress six patients achieved higher tension-time indexes before being limited by fatigue or dyspnea. The observed beneficial effects appear to be partly a result of reduced myocardial oxygen needs and improved oxygen supply.
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