Document Detail


Acute effects of intravenous nicorandil on hemodynamics in patients hospitalized with acute decompensated heart failure.
MedLine Citation:
PMID:  20709498     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Nicorandil injection, a potent vasodilator with K(ATP) channel opening action and nitrate-like action, has been used for treatment of unstable angina. In the present investigation, we examined the effect of intravenous nicorandil on hemodynamics in patients with acute decompensated heart failure (ADHF).
METHODS: ADHF patients admitted to hospital with pulmonary artery wedge pressure (PAWP)≥18 mm Hg were enrolled. Patients received nicorandil by an intravenous bolus injection of 0.2mg/kg/5 min followed by continuous infusion at a rate of 0.05, 0.10, or 0.20mg/kg/h for 6h.
RESULTS: Nicorandil administration caused a significant decrease in PAWP and increase in the cardiac index (CI) that began immediately after the injection and were maintained during the continuous infusion. After 6h, nicorandil administration at 0.2mg/kg/5 min followed by 0.20mg/kg/h resulted in a decrease in PAWP (26.5%, p<0.01), an increase in CI (15.8%, p<0.05), and a decrease in total peripheral resistance (13.8%, p<0.01) in a dose-dependent manner. Nicorandil decreased blood pressure significantly, without an excessive decrease or negative impact even in patients with lower systolic blood pressure.
CONCLUSION: Intravenous administration of nicorandil, by bolus injection followed by continuous infusion, improves PAWP and CI in ADHF patients immediately and continuously as a potent vasodilator with combined preload and afterload reduction. These results demonstrate that nicorandil is a safe and effective new medication for the treatment of ADHF.
Authors:
Keiji Tanaka; Kazuzo Kato; Teruo Takano; Takashi Katagiri; Hidetsugu Asanoi; Jun Nejima; Mitsuyoshi Nakashima; Takeshi Kamijo; Matao Sakanashi
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Publication Detail:
Type:  Journal Article     Date:  2010-08-14
Journal Detail:
Title:  Journal of cardiology     Volume:  56     ISSN:  1876-4738     ISO Abbreviation:  J Cardiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  291-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Division of Intensive and Coronary Care Unit, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113 8603, Japan. k-tanaka@nms.ac.jp
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