Document Detail


Disparate unloading efficacy of the calcium channel blockers, verapamil and nifedipine, on the failing hypertensive left ventricle.
MedLine Citation:
PMID:  6375329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Calcium channel blockers reduce arterial smooth muscle tone and lower blood pressure. They may be regarded as left ventricular (LV) unloading agents. LV unloading efficacy of nifedipine (15 patients) and verapamil (14 patients) was tested in hypertensive decompensated patients, during a 1-month treatment period. Nifedipine persistently reduced systemic vascular resistance (SVR), mean arterial pressure, mean pulmonary wedge pressure (PWP), and LV diastolic diameter, and improved cardiac index and velocity of circumferential fiber shortening (Vcf). All of the patients had relief from dyspnea and reduction in heart size. The only side effect was ankle edema in six. Verapamil reduced SVR and mean arterial pressure and was not effective on PWP, LV diastolic diameter, and Vcf. The drug was discontinued in two patients who developed severe dyspnea at rest after 3 to 4 days of continuous oral treatment. Clinical symptoms and signs did not improve in the remaining patients despite persistent pressure reduction. A less potent vasodilating action of verapamil and a prominent depression in cardiac contractility may account for the differential results with the two compounds, in spite of a shared vasodilating antihypertensive effect. These findings indicate that functional changes in the failing hypertensive heart may differ from one calcium blocker to another as a result of interaction and relative preponderance of influence on afterload and contractility.
Authors:
M D Guazzi; C Cipolla; P Della Bella; F Fabbiocchi; P Montorsi; P Sganzerla
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  108     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1984 Jul 
Date Detail:
Created Date:  1984-07-26     Completed Date:  1984-07-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  116-23     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output
Clinical Trials as Topic
Echocardiography
Female
Heart Failure / drug therapy,  etiology,  physiopathology*
Heart Ventricles / physiopathology
Humans
Hypertension / complications*
Male
Middle Aged
Myocardial Contraction*
Nifedipine / therapeutic use*
Pulmonary Wedge Pressure
Vascular Resistance
Verapamil / therapeutic use*
Chemical
Reg. No./Substance:
21829-25-4/Nifedipine; 52-53-9/Verapamil

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


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