Skip Navigation

European Heart Journal 1994 15(7):957-964;
Copyright © 1994 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by ROUSSEAU, M. F.
Right arrow Articles by POULEUR, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by ROUSSEAU, M. F.
Right arrow Articles by POULEUR, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1994 The European Society of Cardiology

Effects of nisoldipine therapy on myocardial perfusion and neuro-hormonal status in patients with severe ischaemic left ventricular dysfunction

M. F. ROUSSEAU, J. MELIN, C. R. BENEDICT*, S. AHN, D. RAPHAEL, M. BORNEMANN{dagger} and H. POULEUR

Division of Cardiology and the Division of Nuclear Medicine, University of Louvain Medical School
*Department of Cardiology, University of Texas Medical School Houston, Texas, USA
{dagger}Pharma Research Center Bayer A. G., Wuppertal, Germany

Received 2 August 1993; revised 22 February 1994; .

Correspondence: Hubert Pouleur, M/D., University of Louvain, avenue Hippocrate 55/5560, B-1200 Brussels, Belgium.

Abstract

The effects of nisoldipine on regional myocardial perfusion and neuro-hormonal status were assessed in a double-blind, placebo-controlled study of 32 patients. All patients had ischaemic left ventricular dysfunction, with a left ventricular ejection fraction between 25% and 35%; per protocol, they were stratified according to concomitant use of ACE inhibitors. After baseline measurements at rest, including single photon emission computed tomography (SPECT) with Tc-MIBI, plasma neuro-hormones (norephinephrine, renin, arginine vasopressin, atrial natriuretic peptide) and echocardiography, the patients were randomized to nisoldipine (core coat tablet, 20 mg once daily; n=16) or placebo (n=16). Measurements were repeated after 8 weeks. SPECT data were analysed qualitatively (visual comparison by blinded observer) and quantitatively to derive an index of hypoperfusion representing the percentage of the left ventricular mass with Tc-MIBI activity below normal. At baseline, all patients had left ventricular areas with reduced Tc-MIBI uptake and 29 patients also had increases in plasma neuro-hormones. With nisoldipine, the extent of hypoperfusion (quantitative analysis) was reduced in 8114 patients vs only 2114 patients with placebo (P=0.046, 2-tailed test). The benefit of nisoldipine was similar in patients with or without ACE inhibitor therapy and was also confirmed by the visual analysis of the data. Further, none of the neuro-hormones examined was significantly modified by nisoldipine. Thus, chronically underperfused areas are present at rest in patients with ischaemic left ventricular dysfunction, and nisoldipine significantly improved Tc-MIBI uptake in these areas without evidence of detrimental changes in plasma neuro-hormones. The improved perfusion of such ‘hibernating areas’ could explain some of the beneficial changes in left ventricular function observed with nisoldipine in larger studies.

Key Words: Nisoldipine • myocardial perfusion • neuro-hormones • left ventricular dysfunction


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
P. Verdecchia, F. Angeli, C. Cavallini, R. Gattobigio, G. Gentile, J. A. Staessen, and G. Reboldi
Blood pressure reduction and renin-angiotensin system inhibition for prevention of congestive heart failure: a meta-analysis
Eur. Heart J., March 2, 2009; 30(6): 679 - 688.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.