Document Detail

Effects of nicardipine and urapidil on length-dependent regulation of myocardial function in coronary artery surgery patients.
MedLine Citation:
PMID:  10622648     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess effects of a decrease in left ventricular (LV) afterload (pharmacologically induced by nicardipine and urapidil) on myocardial contraction and relaxation, with emphasis on the effects on load dependence of myocardial function. DESIGN: Prospective, blinded study. SETTING: University hospital. PARTICIPANTS: Coronary artery surgery patients. INTERVENTIONS: Alterations of systolic load were effected by leg elevation in control conditions and after administration of either nicardipine or urapidil before and after cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: High-fidelity LV pressure tracings were obtained at end-expiration while hearts were paced at a fixed rate of 90 beats/min. Hemodynamic effects of leg elevation were compared before and after nicardipine, 7 microg/kg (n = 15), and before and after urapidil, 0.4 mg/kg (n = 15). The effects of leg elevation on parameters of contraction and relaxation were coupled. Both nicardipine and urapidil similarly decreased systolic pressures and peripheral resistance. Nicardipine decreased rate of pressure development (dP/dtmax) and slowed LV pressure fall, whereas load dependence of LV relaxation was not altered. Urapidil did not alter dP/dtmax, rate of LV pressure fall, or load dependence of relaxation. Similar results were observed after cardiopulmonary bypass. CONCLUSIONS: The results of the present study indicate that a pharmacologically induced moderate reduction in LV afterload with nicardipine or urapidil did not alter the length-dependent regulation of myocardial function.
S G De Hert; P J Van der Linden; P W Ten Broecke; L A Sermeus; T C Gillebert
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  13     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-02-11     Completed Date:  2000-02-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  677-83     Citation Subset:  IM    
Department of Anesthesiology, University Hospital Antwerp, Belgium.
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MeSH Terms
Adrenergic alpha-Antagonists / pharmacology*
Blood Pressure / drug effects
Calcium Channel Blockers / pharmacology*
Cardiopulmonary Bypass
Coronary Artery Bypass* / methods
Double-Blind Method
Leg / blood supply
Myocardial Contraction / drug effects*
Nicardipine / pharmacology*
Piperazines / pharmacology*
Prospective Studies
Vascular Resistance / drug effects
Vasodilator Agents / pharmacology*
Reg. No./Substance:
0/Adrenergic alpha-Antagonists; 0/Calcium Channel Blockers; 0/Piperazines; 0/Vasodilator Agents; 34661-75-1/urapidil; 55985-32-5/Nicardipine

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

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