UNLABELLED: Nisoldipine (Bay k 5552) is the most potent calcium antagonist known; yet, its cardiovascular effects in man are still under investigation. In the present study 10 consecutive male patients with isolated significant lesion on the left anterior descending coronary artery underwent ECG gated nuclear ventriculography at rest and during submaximal bicycle exercise in the supine position. Following the oral administration of 10 mg of nisoldipine the study was repeated at 90 and 180 min, with the patient in the same position and with the same work load. Left ventricular ejection fraction (EF), end-systolic blood volume index (ESBVI), end-diastolic blood volume index (EDBVI), stroke volume index (SVI), peak left ventricular ejection rate (PER), peak left ventricular filling rate (PFR), time to PER (TPER) and time to PFR (TPFR), and systemic vascular resistance (SVR) were evaluated, regional wall motion was also judged by three independent observers. At rest, a significant (p less than 0.001) decrease of SVR and systolic blood pressure (SBP) was found; a significant (p less than 0.001) decrease of diastolic blood pressure (DBP) and an increase (p less than 0.05) of heart rate (HR), EDBVI and PFR were also registered, the other indexes resulting unaffected. During exercise the reduction of SVR was confirmed. An improvement of the wall motion was found in 4 out of 11 segments at rest and in 9 out of 17 under stress. CONCLUSIONS: nisoldipine shows a predominant peripheral effect, without impairment of cardiac contractility; the improvement of the wall motion of the ischemic regions achieved at similar levels of double product suggests an increased coronary blood flow and a metabolic amelioration.
UNLABELLED: Nisoldipine (Bay k 5552) is the most potent calcium antagonist known; yet, its cardiovascular effects in man are still under investigation. In the present study 10 consecutive male patients with isolated significant lesion on the left anterior descending coronary artery underwent ECG gated nuclear ventriculography at rest and during submaximal bicycle exercise in the supine position. Following the oral administration of 10 mg of nisoldipine the study was repeated at 90 and 180 min, with the patient in the same position and with the same work load. Left ventricular ejection fraction (EF), end-systolic blood volume index (ESBVI), end-diastolic blood volume index (EDBVI), stroke volume index (SVI), peak left ventricular ejection rate (PER), peak left ventricular filling rate (PFR), time to PER (TPER) and time to PFR (TPFR), and systemic vascular resistance (SVR) were evaluated, regional wall motion was also judged by three independent observers. At rest, a significant (p less than 0.001) decrease of SVR and systolic blood pressure (SBP) was found; a significant (p less than 0.001) decrease of diastolic blood pressure (DBP) and an increase (p less than 0.05) of heart rate (HR), EDBVI and PFR were also registered, the other indexes resulting unaffected. During exercise the reduction of SVR was confirmed. An improvement of the wall motion was found in 4 out of 11 segments at rest and in 9 out of 17 under stress. CONCLUSIONS:nisoldipine shows a predominant peripheral effect, without impairment of cardiac contractility; the improvement of the wall motion of the ischemic regions achieved at similar levels of double product suggests an increased coronary blood flow and a metabolic amelioration.