Dilatation of epicardial coronary arteries and attenuation of provoked coronary vasoconstriction by nisoldipine.
By using quantitative coronary angiography, this study evaluated the coronary artery dilative action of intravenous nisoldipine and furthermore examined the efficacy of the agent to prevent an ergonovine-provoked increase in the coronary arterial tone. Ten patients suspected of either vasospastic or mixed form of angina pectoris underwent coronary angiography under resting conditions, after 3 micrograms kg-1 of intravenous nisoldipine and finally after a cumulative dose of 0.7 mg of ergonovine maleate. The ergonovine-provocation was performed subsequent to a second intravenous administration of 3 micrograms kg-1 nisoldipine. Coronary artery diameters were measured in angiographically normal, proximal segments by using a computer assisted procedure with automatic contour detection. The following results are given as the mean +/- SEM of the percentage changes in the diameters of 30 coronary artery segments. Nisoldipine produced dilatation of the epicardial coronary arteries with a mean increase in the diameters by 9.5 +/- 1.3% with respect to baseline (P less than 0.01). Subsequent ergonovine-testing caused coronary artery vasoconstriction with a mean diameter decrease of 7.7 +/- 1.3% below baseline (P less than 0.01). Though nisoldipine did not totally block the ergonovine-induced increase in the coronary vasomotor tone, there was a significant attenuation of the coronary constriction compared with patients without any premedication (7.7 +/- 1.3% versus 13.6 +/- 0.6%, P less than 0.01). The ability of nisoldipine to dilate epicardial coronary arteries but also to reduce a provoked coronary artery constriction promises therapeutic effectiveness for both the prevention and release of angina pectoris caused by an increased coronary vasomotor tone.
Gansser
R E
RE
Universitaet Erlangen-Nuernberg, F.R.G.
Bachmann
K F
KF
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000187:drug effects*; D004874:Ergonovine / Q000037:antagonists & inhibitors; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D015737:Nisoldipine / Q000494:pharmacology*; D011292:Premedication; D014664:Vasodilation / Q000187:drug effects*
D015737:Nisoldipine; D004874:Ergonovine