Advertisement

Hemodynamic Effects of Intravenous Nisoldipine and Nitroglycerin in Patients with Coronary Heart Disease

  • F. C. Dougherty
  • M. Schartl
  • H. Schmutzler
Conference paper

Summary

In a biometrically planned, controlled group comparison study comprising 12 patients with angiographically verified coronary heart disease, we determined the effects of a single IV dose of nisoldipine ( 6 µg/kg body weight) on hemodynamic parameters at rest and during bicycle exercise and compared these results with those recorded after a single IV dose of nitroglycerin (0.5 mg). Informed consent was obtained, and each patient underwent conventional cardiac catheterization with coronary angiography and complete hemodynamic studies in the pulmonary vascular bed and systemic circulation. After a stabilization period and determination of baseline hemodynamic parameters for purposes of profile analysis, a standardized bicycle exercise test was performed until chest pain developed or characteristic ST-segment depression was documented. Study parameters were recorded with repeat determinations after 30 min. Following injection of the test medication, study parameters were again recorded at baseline, after bicycle exercise, and after recovery.

Statistical evaluation demonstrated no significant differences between the two groups with regard to demographic parameters as well as total peripheral resistance, cardiac index, derived parameters, and mean pulmonary artery pressure at baseline. Intravenous administration of a single dose of nisoldipine (6µg/kg body weight over 3 min) was followed by a significant decrease in total peripheral resistance and significant increases in cardiac index, stroke volume index, and other derived parameters. Opposite effects were found after administration of nitroglycerin. Analysis using a model of covariance reveals a highly significant difference in therapeutic effect for these parameters between the two interventions. This reflects the different sites of action of the two drugs with corresponding implications for their use in treating patients with coronary heart disease.

Keywords

Coronary Heart Disease Cardiac Index Pulmonary Artery Pressure Total Peripheral Resistance Bicycle Exercise 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kazda S, Garthoff B, Meyer H, Schloßmann K, Stoepel K, Towart R, Vater W, Wehinger E. Pharmacology of a new calcium antagonistic compound, isobutyl methyl 1,4-dihydro-2,6- dimethyl-4-(2-nitrophenyl)-3,5-pyridine-dicarboxylate (nisoldipine, BAY k 5552). Arzneim Forsch/Drug Res (1980); 30: 2144–2162.Google Scholar
  2. 2.
    Saida K, van Breemen C. Mechanism of Ca2+antagonist-induced vasodilatation. Circ Res (1983); 52: 137–142.PubMedGoogle Scholar
  3. 3.
    Vogt A, Neuhaus K, Kreuzer H. Hemodynamic effects of the new vasodilator drug BAY k 5552 in man. Arzneim Forsch /Drug Res (1980); 36(11): 2162–2164.Google Scholar
  4. 4.
    Kazda S, Garthoff B, Luckhaus G. Ca2+antagonists in hypertensive disease: experimental evidence for a new therapeutic concept. Postgrad Med J (1983); 59 (suppl 2): 78–83.PubMedGoogle Scholar
  5. 5.
    Lam J, Chaitman BR, Crean P, Blum R, Waters DD. A dose-ranging, placebo-controlled, doubleblind trial of nisoldipine in effort angina: duration and extent of antianginal effects. JACC (1985); 6: 447–452.PubMedGoogle Scholar
  6. 6.
    Lopez LM, Rubin MR, Holland JP, Mehta JL. Improvement in exercise performance with nisoldipine, a new second-generation calcium blocker, in stable angina patients. Am Heart J (1985); 110: 991–996.PubMedCrossRefGoogle Scholar
  7. 7.
    Silke B, Frais MA, Muller P, Verma SP, Reynolds G, Taylor SH. Hemodynamic dose-response effects of intravenous nisoldipine in coronary artery disease. Br J Clin Pharmacol (1985); 20: 675–680.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • F. C. Dougherty
  • M. Schartl
  • H. Schmutzler

There are no affiliations available

Personalised recommendations