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Haemodynamic dose‐response effects of intravenous nisoldipine in coronary artery disease.
Author(s) -
Silke B.,
Frais MA,
Muller P.,
Verma SP,
Reynolds G.,
Taylor SH
Publication year - 1985
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1985.tb05127.x
Subject(s) - nisoldipine , medicine , cardiac output , cardiology , stroke volume , ejection fraction , coronary artery disease , vascular resistance , pulmonary artery , blood pressure , supine position , anesthesia , angina , hemodynamics , nifedipine , myocardial infarction , heart failure , calcium
The circulatory consequences of slow‐calcium channel blockade with a new dihydropyridine nisoldipine were evaluated at rest and during exercise‐induced angina in 16 patients with angiographically proven coronary artery disease. In 10 patients resting cardiac stroke output (thermodilution) and pulmonary artery occluded pressure were determined following four intravenous nisoldipine injections (cumulative dosage of 1, 2, 4 and 8 micrograms kg‐1). The exercise effects of nisoldipine were evaluated by comparing the effects of the 8 micrograms kg‐1 cumulative dosage with a control exercise period at the same workload. At rest nisoldipine reduced systemic vascular resistance and mean arterial pressure, and increased heart rate, cardiac and stroke volume indices. During 4 min supine‐bicycle exercise nisoldipine reduced systemic mean arterial pressure and vascular resistance; this resulted in augmented cardiac and stroke volume indices at an unchanged pulmonary artery occluded pressure. In six additional patients rest and exercise ejection fractions were measured using a nonimaging nuclear probe. Nisoldipine (4 micrograms kg‐1) resulted in a small trend to increase left ventricular rest and exercise ejection fraction. These data demonstrated improved rest and exercise cardiac performance following nisoldipine in patients with severe coronary artery disease.