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European Heart Journal 1993 14(Supplement A):45-47; doi:10.1093/eurheartj/14.suppl_A.45
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Nisoldipine in severe ischaemic left ventricular dysfunction

H. Pouleur and M. F. Rousseau

Department of Physiology and Pharmacology, Division of Cardiology, University of Louvain Brussels, Belgium

Correspondence: Hubert Pouleur, MD, University of Louvain, av Hippocrate 55/5560, B-1200 Brussels, Belgium.

The use of calcium antagonists in patients with severe dysfunction is controversial because agents like verapamil, diltiazem and nifedipine have been shown to worsen or precipitate congestive heart failure.

However, successive improvements in our understanding of the clinical pharmacology of these drugs, of their pharmacokinetics and of their action on several neuro-humoral regulatory mechanisms have led to a continuous improvement of the molecules available. Promising results have been obtained with nisoldipine in patients with ischaemic left ventricular dysfunction (improved exercise tolerance, improved diastolic filling probably related to a relative improvement of chronically ischaemic areas) and other studies are exploring the effects of the combination of nisoldipine with an ACE-inhibitor. Soon, these trials should tell us if there is a real clinical benefit in the use of this agent not only to improve symptoms but also to slow down progression of the ventricular dysfunction.

Key Words: Nisoldipine • diastolic function • hibernating myocardium


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