Document Detail


Effects of nicardipine or nifedipine added to propranolol in patients with coronary artery disease.
MedLine Citation:
PMID:  6527976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the added effects of nicardipine and beta-blockers on the left ventricular (LV) function, 2.5 mg of i.v. nicardipine was given to 9 patients with coronary artery disease, pretreated with propranolol (0.1 mg/kg, i.v.). The changes in LV function observed after nicardipine were compared with those induced by nifedipine (20-30 mg sublingually), in 8 comparable patients also pretreated with propranolol. Nicardipine normalized the cardiac output and the rate of LV relaxation, both depressed by propranolol, without changes in LV filling pressure. After nicardipine, end-systolic volume (52 to 42 ml/m2; P less than 0.01) and ejection fraction (59 +/- 8 to 66 +/- 9%; P less than 0.01) improved; the mean systolic and diastolic wall stresses decreased respectively by 19% (P less than 0.01) and 21% (P less than 0.01) whereas the maximal LV pressure/volume ratio (Emax), an index of LV inotropic state, was unchanged (+4%; NS). Further, although nicardipine and nifedipine produced identical changes in LV systolic pressure (-25 vs -26 mmHg; NS nicardipine vs nifedipine) and in heart rate, the changes in end-systolic volume (-9 +/- 4 vs -3 +/- 9 ml/m2; P less than 0.005), in Emax (+0.14 +/- 0.31 vs -0.20 +/- 0.22 mmHg/ml/m2; P less than 0.025) and in ejection fraction (+7 +/- 4 vs +2 +/- 4%; P less than 0.025) were significantly greater after nicardipine than after nifedipine. In conclusion, nicardipine administered after propranolol improves LV pump function and has no negative inotropic effects as indicated by the lack of dP/dt Max and Emax changes. These additive effects of nicardipine after propranolol were greater than those of nifedipine administered at an equipotent vasodilator dosage.
Authors:
H Pouleur; J Etienne; H Van Mechelen; C Van Eyll; A A Charlier; L A Brasseur; M F Rousseau
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  60 Suppl 4     ISSN:  0032-5473     ISO Abbreviation:  Postgrad Med J     Publication Date:  1984  
Date Detail:
Created Date:  1985-04-19     Completed Date:  1985-04-19     Revised Date:  2009-10-22    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  23-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / drug effects
Calcium Channel Blockers / pharmacology*,  therapeutic use
Coronary Disease / drug therapy,  physiopathology*
Drug Therapy, Combination
Female
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Myocardial Contraction / drug effects
Nicardipine
Nifedipine / analogs & derivatives*,  pharmacology*,  therapeutic use
Propranolol / pharmacology*,  therapeutic use
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 525-66-6/Propranolol; 55985-32-5/Nicardipine

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


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