By Robert Charlier
If the varied healing acquisitions of the earlier few years have enriched very varied fields of human pathology, it does appear that coronary pathology has been given very unique consciousness, as witness the big variety of antianginal drugs positioned on the disposal of the scientific occupation. there are numerous factors for this situation, one in every of them most likely being that the medica tions successively proposed don't totally fulfill the practitioner and one other that the entire variety of members being affected by the clinicaI manifestations of heart sickness deals, by means of its measurement, an enormous revenue power for the pharma ceuticaI undefined. This box of purposes opens up such clients that it has inspired a prolific volume of pageant among a number of learn laborato ries, and it's no exaggeration to claim that each significant enterprise has its individuaI anti anginaI drug in its healing cataIogue. yet another issue has aIso contributed greatly to this proliferation of medi cinal arrangements meant for the remedy of angina pectoris: this can be the fast enhance in our knowIedge of the physiopathoIogy of angina, which in flip has produced originaI innovations of pharmacological and biochemical study. hence, there have emerged new ingredients whose motion mechanisms have claimed to be most fitted to the cardiovascular problems liable for cardiac ache.
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Extra resources for Antianginal Drugs: Pathophysiological, Haemodynamic, Methodological, Pharmacological, Biochemical and Clinical Basis for Their Use in Human Therapeutics
SimiIarly, in patients with refraetory angina peetoris due to severe eoronary artery disease, measurements of left ventrieuIar ehamber volume and mass indieated the presenee of left ventricle dilatation and a proportional hypertrophy, whieh are interpreted as manifestations of redueed left ventrieular performance [264e]. To complete the diseussion on the eardiovaseuIardisorders charaeteristie ofangina peetoris,mention may be made of the pulmonaryand cutaneous eireulatory systems. Regional distribution of pulmonary blood Howand ventiIation was determined with the 138Xe teehnic in the ereet position at the bedside in 15 patients an average of 6 days after uncomplicated myoeardial infaretion and in five patients with severe angina.
Pathophysiology of the Anginal Attack 25 what occurs in the healthy subject, the extraction of oxygen by the myocardium, alreadyat a very high level in the resting state (see Chap. II), is increased in cases of coronary insufficiency during exertion. This phenomenon is indicative of an inadequate coronary reserve and of the exhaustion of the reserve of arterial dilatation, this despite the presence of an increased How, this not being sufficient to satisfy fuUy the increase in oxygen demands. COHEN et al.
As far as the physiopathology of the different forms of angina peetoris is coneerned, we ean summarise GORLIN'S opinion in the form of 0. table (see Table 1). A further elinieal proof, this time indireet, of the part played by the sympathetie system in angina is that eleetrieal stimulation of the earotid sinus nerve brings to the sufferer immediate rellef from the attack  and prevents it oeeurring during exereise  14: it involves 0. reflex reduetion of the sympathetie tonicity in the heart and arterlal vessels whieh leada to an immediate lessening in the heart rate, mean blood pressure and global vaseular resistanee .
Antianginal Drugs: Pathophysiological, Haemodynamic, Methodological, Pharmacological, Biochemical and Clinical Basis for Their Use in Human Therapeutics by Robert Charlier