title: Hemodynamic changes after subselective intracoronary administration of nisoldipine in humans.
abstract: Hemodynamic changes after the subselective intracoronary administration of 50 micrograms of nisoldipine were analyzed in 24 nonstenotic coronary arteries using a randomized, placebo-controlled, double-blind protocol. The following hemodynamic parameters were studied: (a) epicardial coronary artery diameter, assessed by quantitative angiography; (b) coronary blood flow velocity, measured by an intracoronary Doppler probe; (c) coronary blood flow, calculated from the above parameters; (d) coronary flow velocity reserve, assessed after intracoronary administration of 10 mg of papaverine hydrochloride; and (e) heart rate and arterial blood pressure. Since 3 patients were excluded due to unreliable Doppler signals, a total of 21 patients was eligible for complete analysis (placebo: n = 9; nisoldipine: n = 12). In placebo-treated patients, all studied parameters proved to be very stable on repeat measurement and no significant changes were found. In nisoldipine-treated patients, a significant increase in epicardial diameter (+19%; p = 0.0001) and coronary blood flow (+47%; p = 0.003) was found. The coronary blood flow velocity transiently increased after nisoldipine, with a maximum (+80%) after 2 min and returning to baseline within 10 min. Finally, nisoldipine resulted in a significant decrease in the coronary flow velocity reserve by 20% (p = 0.001). All coronary hemodynamic effects were observed in the absence of changes in heart rate and arterial blood pressure. Therefore, the present data demonstrate that nisoldipine acts as a potent dilator of epicardial as well as resistance vessels in nonstenotic human coronary arteries.
authors.affiliation: Department of Cardiology, University Hospital of Gasthuisberg, Leuven, Belgium.
authors.forename: M C
authors.initials: MC
authors.lastname: Vrolix
authors.forename: D
authors.initials: D
authors.lastname: Sionis
authors.forename: J
authors.initials: J
authors.lastname: Piessens
authors.forename: I
authors.initials: I
authors.lastname: de Scheerder
authors.forename: J L
authors.initials: JL
authors.lastname: Willems
authors.forename: H
authors.initials: H
authors.lastname: De Geest
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015737:Nisoldipine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010208:Papaverine / Q000494:pharmacology; D012212:Rheology
chemical_list: D015737:Nisoldipine; D010208:Papaverine