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Coronary and systemic hemodynamic effects of nicardipine
Ist Teil von
The American journal of cardiology, 1985-03, Vol.55 (6), p.652-656
Ort / Verlag
New York, NY: Elsevier Inc
Erscheinungsjahr
1985
Quelle
Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)
Beschreibungen/Notizen
Systemic and coronary hemodynamic effects of a new dihydropyridine calcium antagonist, nicardipine, were studied in 15 patients. Nicardipine was administered as a 2-mg bolus intravenously followed by an infusion titrated to maintain a 10 to 20-mm Hg decrease in systolic pressure. Nicardipine increased both heart rate from 69 ± 3 to 81 ± 3 beats/min and cardiac output from 7.3 ± 0.5 to 9.9 ± 0.5 liters/min (both p < 0.001) as systemic vascular resistance decreased from 1,183 ± 70 to 733 ± 33 dynes s cm
−5 (p < 0.001). Left ventricular end-diastolic pressure remained constant, at 14 ± 1 vs 14 ± 1 mm Hg as stroke volume increased from 108 ± 6 to 123 ± 6 ml/m
2 (p < 0.001). Coronary blood flow increased from 102 ± 9 to 147 ± 13 ml/min, while coronary resistance decreased from 1.17 ± 0.1 to 0.7 ± 0.1 mm Hg/ml/min (both p < 0.001). Heart rate-systolic blood pressure product did not change (104 ± 5 vs 106 ± 5 beats/min mm Hg × 10
−2, difference not significant) with drug administration. At the same heart rate before and during nicardipine administration (using atrial pacing in 6 patients), significant augmentation of coronary flow was still observed. Thirteen of 14 patients showed a greater percent decrease in coronary resistance than systemic vascular resistance. Nicardipine differs from other calcium antagonists with respect to consistent augmentation of coronary blood flow. This effect appears to be the result, in part, of increased potency in the coronary bed compared with the systemic vascular bed.