Diagnosis, evaluation and treatment of coronary artery disease by exercise simulation using closed loop drug delivery of an exercise simulating agent beta agonist
First Claim
1. A method of eliciting in a mammal immediate physical responses similar to those physical responses elicited by aerobic activity comprising the steps of:
- administering an exercise simulating agent by a closed loop drug delivery device;
controlling the rate of infusion of said exercise simulating agent into the bloodstream of said mammal by a power source operatively connected to said delivery device, said device carrying said exercise simulating agent and being operatively connected to said mammal, wherein said power source is regulated by a microprocessor operatively connected to both said power source and an electrocardiographic heart rate monitoring device operatively connected to said mammal;
said exercise simulating agent being introduced in sufficient amount to induce reversible myocardial ischemia when coronary artery disease is present; and
said exercise simulating agent having the chemical formula;
##STR9## wherein X1 and X2 are independently hydrogen, hydroxy, methoxy or carbamoyl, provided that X1 and X2 are not both hydrogen or carbamoyl;
one of Y1 and Y2 is hydrogen and the other is hydrogen or methyl, provided that if Y1 is methyl, then X1 is not carbamoyl;
Z is hydrogen or hydroxy; and
n is 2 or 3;
or a pharmaceutically acceptable acid addition salt thereof.
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Accused Products
Abstract
Methods and devices for the diagnosis, evaluation and treatment of coronary artery disease (CAD) by means of a closed-loop drug delivery system that delivers an exercise simulating agent, including novel exercise simulating agents which elicit both acute and adaptive cardiovascular responses similar to those elicited by aerobic activity are provided. The acute responses to the exercise simulating agent are used to diagnose and evaluate CAD in lieu of the acute responses to aerobic exercise. Due to their adaptive responses these compounds may be used to treat CAD in lieu of the adaptive responses caused by aerobic exercise training or to treat other conditions where the adaptive responses caused by aerobic exercise are desirable.
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Citations
44 Claims
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1. A method of eliciting in a mammal immediate physical responses similar to those physical responses elicited by aerobic activity comprising the steps of:
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administering an exercise simulating agent by a closed loop drug delivery device; controlling the rate of infusion of said exercise simulating agent into the bloodstream of said mammal by a power source operatively connected to said delivery device, said device carrying said exercise simulating agent and being operatively connected to said mammal, wherein said power source is regulated by a microprocessor operatively connected to both said power source and an electrocardiographic heart rate monitoring device operatively connected to said mammal; said exercise simulating agent being introduced in sufficient amount to induce reversible myocardial ischemia when coronary artery disease is present; and said exercise simulating agent having the chemical formula;
##STR9## wherein X1 and X2 are independently hydrogen, hydroxy, methoxy or carbamoyl, provided that X1 and X2 are not both hydrogen or carbamoyl;
one of Y1 and Y2 is hydrogen and the other is hydrogen or methyl, provided that if Y1 is methyl, then X1 is not carbamoyl;
Z is hydrogen or hydroxy; and
n is 2 or 3;
or a pharmaceutically acceptable acid addition salt thereof. - View Dependent Claims (2, 3, 4, 5)
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- 6. A method of eliciting in a mammal immediate cardiovascular responses similar to those cardiovascular responses elicited by aerobic activity for diagnostic purposes, comprising the administration of an exercise simulating agent with beta adrenergic activity which elicits immediate cardiovascular responses similar to those cardiovascular responses elicited by aerobic activity by closed loop drug delivery device wherein said exercise simulating agent is administered for diagnostic purposes by transdermal iontophoretic infusion and comprises a catecholamine which induces reversible myocardial ischemia when coronary artery disease is present.
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17. A method of simulating the cardiovascular responses of a mammal to an exercise stress test wherein the heart of said mammal is exercised or stressed at a selected level without body motion which comprises:
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(a) administering to said mammal an exercise simulating agent having beta adrenergic activity by a closed loop drug delivery device wherein said exercise simulating agent induces reversible myocardial ischemia in said mammal and is administered in an amount effective to obtain a preselected range of physical responses in said mammal; (b) controlling infusion of said exercise simulating agent into said mammal'"'"'s bloodstream so as to maintain said preselected range of responses for a preselected time period; and (c) discontinuing infusion of said exercise simulating agent when said preselected time period has expired, or when said physical responses are outside said preselected range. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A method of diagnosing and evaluating coronary artery disease in a mammal by eliciting in said mammal immediate cardiovascular responses similar to those cardiovascular responses elicited by aerobic activity which comprises:
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(a) administering an exercise simulating agent to said mammal by closed loop drug delivery device; (b) controlling infusion of said exercise simulating agent into the blood stream of said mammal so that a predetermined range of cardiovascular responses of said mammal is obtained; (c) monitoring the range of responses of said mammal; (d) changing infusion of said exercise simulating agent as required to maintain said range of responses in said mammal; and (e) evaluating said responses. - View Dependent Claims (29, 30, 31, 32, 33)
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34. A method of diagnosing and evaluating coronary artery disease by simulating the cardiovascular responses of a mammal to an exercise stress test wherein the heart of said mammal is exercised or stressed at a selected level without body motion which comprises:
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(a) administering to said mammal an exercise simulating agent by a closed loop drug delivery device wherein said exercise simulating agent induces reversible myocardial ischemia if coronary artery disease is present in said mammal and is administered in an amount effective to obtain a preselected range of physical responses in said mammal; (b) controlling infusion of said exercise simulating agent into said mammal'"'"'s bloodstream so as to maintain said preselected range of responses for a preselected time period; (c) discontinuing infusion of said exercise simulating agent when said preselected time period has expired or when said physical responses are outside said preselected range; and (d) evaluating said physical responses. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43, 44)
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Specification