Document Detail


Improved diastolic function with the calcium antagonist nisoldipine (coat-core) in patients post myocardial infarction: results of the DEFIANT study. Doppler Flow and Echocardiography in Functional cardiac Insufficiency: Assessment of Nisoldipine Therapy.
MedLine Citation:
PMID:  1464339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial was undertaken in 135 patients to determine whether 4 weeks of treatment with long-acting nisoldipine coat-core (20 mg once a day) could alter diastolic function in patients with a recent myocardial infarction and with mild left ventricular dysfunction as indicated by a left ventricular ejection fraction < or = 50%. The primary endpoint was the change in diastolic filling parameters assessed by Doppler and two-dimensional echocardiography. The mean time of admission to the study was 20 days (range 7-35) after myocardial infarction. Mean left ventricular ejection fraction was 41%. The drug increased early diastolic peak velocity at the tips of the mitral leaflet by 0.06 m.s-1 (95% confidence intervals (CI): 0.01, 0.11). The time velocity integral was increased by 1.2 cm (95% CI: 0.16, 2.27). These findings are indicative of increased early diastolic flow across the mitral valve. An important determinant appeared to be a reduced isovolumic relaxation time (by 14.7 ms, 95% CI: -22.5, -6.9). As there was no change in heart rate, systolic and diastolic blood pressure or cardiac output, afterload reduction appeared unlikely as an explanation. Peak workload on exercise was 12 watts higher in the group on nisoldipine (95% CI: 0.8, 23.3). Thus, nisoldipine was shown to improve indices of diastolic ventricular function, as well as exercise capacity, in this group of patients. The observed effects of nisoldipine may reflect an anti-ischaemic effect or be due to improved relaxation of the myocardium.
Authors:
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  13     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1993-01-15     Completed Date:  1993-01-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1496-505     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Delayed-Action Preparations
Double-Blind Method
Echocardiography
Exercise Test
Female
Humans
Male
Middle Aged
Myocardial Contraction / drug effects*
Myocardial Infarction / drug therapy*,  ultrasonography
Nisoldipine / administration & dosage,  therapeutic use*
Single-Blind Method
Time Factors
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 63675-72-9/Nisoldipine

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


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