Hemodynamic Effects of Intravenous Nisoldipine
The hemodynamic effects of intravenous nisoldipine were assessed in two groups of patients undergoing routine catheterization for ischemic heart disease. In the first group (n = 12) a bolus of 6 µg/kg was administered over 3 min and in the second group (N = 13) an initial bolus of 4.5 µg/kg was followed by a continuous infusion of 0.2 µg/kg per min. Observations including coronary sinus blood flow (CSBF), coronary (CVR) and systemic vascular (SVR) resistance and myocardial oxygen consumption (MVO2) were recorded over a 30 min observation period. In the second group of patients, additional observations were recorded during atrial pacing 20 beats/min above the resting rate, both prior and during nisoldipine infusion, so that the hemodynamic data obtained could be compared independent of heart rates (HR).
Following bolus administration of nisoldipine there was a significant fall in systemic (−36%) and coronary (−25%) vascular resistance with an increase in heart rate (+20%) and cardiac index (CI) (+35%). Over the 30-min observation period there was a trend for all variables to return to control values although all but CVR and CSBF remained significantly different.
The results obtained during matched pacing are compared in table 2. Despite the significant reduction in SVR and CVR resulting in an increase in CO and CSBF, there was no significant change in MVO2. We conclude that nisoldipine is a potent coronary and peripheral vasodilator which increases the myocardial supply of oxygen in excess of demand when administered intravenously.
KeywordsCardiac Index Systemic Vascular Resistance Aortic Pressure Myocardial Oxygen Consumption Atrial Pace
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