Document Detail

Analysis of the mechanisms underlying the changes in left ventricular filling dynamics during oral nisoldipine therapy in patients with anterior myocardial infarction.
MedLine Citation:
PMID:  1644087     Owner:  NLM     Status:  MEDLINE    
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 LV function was analysed before and after 2 months of double-blind monotherapy 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 less than 0.01) and the LV pressure at the time of mitral opening (-2.0 +/- 3.4 mmHg vs +3.5 +/- 3.0; P less than 0.01). Despite this reduction in driving pressure, the global LV 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 +/- 360 to 1339 +/- 496 mm2.s-1 (P less than 0.001). The time to regional peak filling rate (-8%; P less than 0.01), the asynchrony of diastolic wall motion and the regional ejection fraction (33 +/- 10 to 38 +/- 12%; P less than 0.001) also improved in the anterior areas with nisoldipine but not with the placebo. In contrast, in the inferior, control zones, the regional ejection fraction and filling rate remained unchanged, both when compared to baseline and to the placebo.(ABSTRACT TRUNCATED AT 250 WORDS)
H Pouleur; C van Eyll; O Gurné; M F Rousseau
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European heart journal     Volume:  13     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-09-10     Completed Date:  1992-09-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  952-9     Citation Subset:  IM    
Department of Physiology and Pharmacology, University of Louvain, Medical School, Brussels, Belgium.
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MeSH Terms
Dose-Response Relationship, Drug
Double-Blind Method
Heart Catheterization / instrumentation
Hemodynamics / drug effects*,  physiology
Middle Aged
Myocardial Contraction / drug effects,  physiology
Myocardial Infarction / drug therapy*,  physiopathology
Nisoldipine / administration & dosage*
Signal Processing, Computer-Assisted / instrumentation
Ventricular Function, Left / drug effects*,  physiology
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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