Analysis of the mechanisms underlying the changes in left ventricular filling dynamics during oral nisoldipine therapy in patients with anterior myocardial infarction

The aim of this study was to clarify the mechanisms responsible for the increase in early filling rate observed during oral nisoldipine therapy in patients with ischaemic left ventricular (LV) dysfunction. For that purpose, the global and regional L Vfunction was analysed before and after 2 months o...

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Bibliographic Details
Published in:European heart journal 1992-07, Vol.13 (7), p.952-959
Main Authors: POULEUR, H., VAN EYLL, C., GURNÉ, O., ROUSSEAU, M. F.
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiac Catheterization - instrumentation
Cardiovascular system
diastolic function
Dose-Response Relationship, Drug
Double-Blind Method
Female
Hemodynamics - drug effects
Hemodynamics - physiology
hibernating myocardium
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Myocardial Contraction - drug effects
Myocardial Contraction - physiology
myocardial infarction
Myocardial Infarction - drug therapy
Myocardial Infarction - physiopathology
Nisoldipine
Nisoldipine - administration & dosage
Pharmacology. Drug treatments
Signal Processing, Computer-Assisted - instrumentation
Ventricular Function, Left - drug effects
Ventricular Function, Left - physiology
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Summary:The aim of this study was to clarify the mechanisms responsible for the increase in early filling rate observed during oral nisoldipine therapy in patients with ischaemic left ventricular (LV) dysfunction. For that purpose, the global and regional L Vfunction was analysed before and after 2 months ofdouble-blindmonotherapy with nisoldipine (10 mg twice daily) or a placebo, in 17 patients with a previous anterior myocardial infarction. The baseline LV ejection fraction ranged from 34–51% and no patient had heart failure. Compared to the placebo, nisoldipine significantly lowered LV systolic pressure and end-diastolic pressure ( −3 mmHg vs + 6 with the placebo; P < 0.01) and the L V pressure at the time of mitral opening ( −.20 ± 3.4 mmHg vs + 3.5 ± 3.0; P < 0.01). Despite this reduction in driving pressure, the global L V early peak filling rate improved with nisoldipine only and this improvement was related to a selective increase in expansion rate of the anterior areas, from 1010±360to 1339 ±496 mm2.s−1 (P
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a060299