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European Heart Journal 1989 10(5):429-436;
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Acute and chronic effects of nicardipine on rest and exercise haemodynamics in post-myocardial infarction patients with latent cardiac failure

M. T. LA ROVERE, A. MORTARA, C. OPASICH and G. SPECCHIA*

Divisione di Cardiologia Centro Medico Montescano Fondazione Clinica del Lavoro IRCCS Pavia Italy
*Cattedra di Semeiotica Cardiovascolare Universita di Pavia Pavia Italy

Received 7 June 1988; revised 3 November 1988; .

Address for correspondence and reprints: Maria Teresa La Rovere MD, Divisione di Cardiologia, Centro Medico Montescano, 27040 Mpntescano, Pavia, Italy.

Abstract

The acute and chronic haemodynamic effects of nicardipine were studied, at rest and during exercise, in 10 post-myocardial infarction patients with latent cardiac failure and no signs of residual my ocardial ischaemia. Intravenous administration of nicardipine (5 mg over 10 min) was associated with a significant increase in cardiac index and significant reductions in mean pulmonary artery pressure, mean pulmonary wedge pressure, total pulmonary resistance and systemic vascular resistance under conditions of rest and peak exercise. After 3 weeks of oral treatment (20 mg three times daily) cardiac index did not change, but the improvements in mean pulmonary artery pressure, mean pulmonary wedge pressure and total pulmonary resistance were sustained at rest and during exercise, at the same workload attained prior to medication. Chronic treatment with nicardi–pine significantly increased exercise tolerance, while mean pulmonary artery pressure, mean pulmonary wedge pressure and total pulmonary resistance were maintained below the control values. It is concluded that nicardipine improves both rest and exercise cardiac performance in post–myocardial infarction patients with latent cardiac failure, thus avoiding the risk of pulmonary congestion.

Key Words: Nicardipine • latent cardiac failure • post-myocardial infarction patients


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