Summary
The acute haemodynamic effects of the new calcium antagonist isradipine have been studied in ten hypertensive cardiac transplant recipients. Isradipine 0.01 mg·kg−1 was given IV during right heart catheterization and noninvasively automatic blood pressure measurements.
From a baseline blood pressure of 164/114 mm Hg the maximum blood pressure reduction was 35 mm Hg systolic, 30 mm Hg diastolic, and mean 34 mm Hg, due to a reduction in systemic vascular resistance, maximum 43%. Cardiac index increased 32%, mainly due to an increase in the stroke volume, as the heart rate rose only by 10%. Left ventricular filling pressure was slightly reduced.
We conclude that the main effect of isradipine was a major reduction in left ventricular afterload, comparable to that previously found in other patient groups.
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References
Olivari MT, Antolick A, Ring WS (1989) Arterial hypertension in heart transplant recipients treated with triple-drug immuno-suppressive therapy. J Heart Transplant 8: 34–39
Starling RC, Cody RJ (1990) Cardiac transplant hypertension. Am J Cardiol 65: 106–111
Frohlich ED, Ventura HO, Ochsner JL (1990) Arterial hypertension after orthotopic cardiac transplantation. J Am Coll Cardiol 15: 1102–1103
Mark AL (1990) Cyclosporine, sympathetic activity, and hypertension. N Engl J Med 323: 748–750
Jessup M, Cavarocchi N, Narins B, McClurken J, Kolff J (1988) Antihypertensive therapy in patients after cardiac transplantation: a step-care approach. Transplant Proc 20 [Suppl 1]: 801–802
Bennett WM, Porter GA (1988) Cyclosporine-associated hypertension. Am J Med 85: 131–133
Bellet M, Cabrol C, Sassano P, Leger P, Corvol P, Menard J (1985) Systemic hypertension after cardiac transplantation: effect of cyclosporine on the renin-angiotensin-aldosterone system. Am J Cardiol 56: 927–931
Angermann CE, Spes CH, Anthuber M, Kemkes BM, Theisen K (1988) Verapamil increases cyclosporine A blood trough levels in cardiac transplant recipients. J Am Coll Cardiol 11 [Suppl]: 206A
Hof RP (1987) Comparison of cardiodepressant and vasodilator effects of PN 200-110 (isradipine), nifedipine and diltiazem in anaesthetized rabbits. Am J Cardiol 59: 37B-42B
Griebenow R, Kaufmann W, Krämer L, Steffen HM, Wambach G, Burger KJ, Welzel D (1990) Isradipine: a new calcium antagonist with strong vasodilatory, but negligible cardiodepressive effects. J Cardiovasc Pharmacol 15 [Suppl 1]: S84-S86
Schwinger RHG, Böhm M, Erdmann E (1990) Negative inotropic properties of isradipine, nifedipine, diltiazem and verapamil in diseased human myocardial tissue. J Cardiovasc Pharmacol 15: 892–899
Fitton A, Benfield P (1990) Isradipine. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in cardiovascular disease. Drugs 40: 31–74
Berg KJ, Holdaas H, Endresen L, Fauchald P, Hartmann A, Pran J, Solbu D (1991) Effects of isradipine on renal function in cyclosporine-treated renal transplanted patients. Nephrol Dial Transplant 6: 725–730
Kirkendall WM (1988) Comparative assessment of first-line agents for treatment of hypertension. Am J Med 84 [Suppl 3B]: 32–41
Grossman E, Messerli FH, Oren S, Nunez B, Garavaglia G (1991) Cardiovascular effects of isradipine in essential hypertension. Am J Cardiol 68: 65–70
Øvrum E, Geiran O, Lindberg H, Frøysaker T, Simonsen S, Forfang K, Ihlen H, Åm Holen E, Amlie JP, Abdelnoor M, Foerster A, Thorsby E (1988) Three years experience with heart and heart-lung transplantation in Norway. Transplantat Proc 20: 459–461
Stone PH, Antman EM, Muller JE, Braunwald E (1980) Calcium channel blocking agents in the treatment of cardiovascular disorders, part II. Hemodynamic effects and clinical applications. Ann Intern Med 93: 886–904
Silke BM, Frais A, Midtbo KA, Verma SP, Sherma S, Reynolds G, Jackson N, Taylor SH (1987) Comparative hemodynamic dose-response effects of five slow calcium channel-blocking agents in coronary artery disease. Clin Pharmacol Ther 42: 381–387
Regitz V, Bossaller C, Strasser R, Schuler S, Hetzer R, Fleck E (1990) Myocardial catecholamine content after heart transplantation. Circulation 82: 620–623
Bristow MR (1990) The surgically denervated, transplanted human heart. Ciruculation 82: 658–660
Persson B, Andersson OK, Wysocki M, Hedner T, Aurell M (1989) Renal and hemodynamic effects of isradipine in essential hypertension. Am J Med 86 [Suppl 4A]: 60–64
Van den Berg EK, Dehmer GJ (1988) Acute hemodynamic effects of intravenous isradipine. Am J Cardiol 61: 1102–1105
Bedotto JB, Eichhorn EJ, Popma JJ, Dehmer GJ (1990) Effects of intravenous isradipine on left ventricular performance during rapid atrial pacing in coronary artery disease. Am J Cardiol 65: 189–194
Burger W, Neidel S, Kober G (1989) Hemodynamic and antianginal effects during rest and exercise of intravenous isradipine, a new dihydropyridine calcium antagonist. Clin Cardiol 12: 393–398
Taira N (1987) Differences in cardiovascular profile among calcium antagonists. Am J Cardiol 59: 24B-29B
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Aass, H., Simonsen, S. Acute haemodynamic effects of isradipine in hypertensive heart transplant recipients. Eur J Clin Pharmacol 45, 187–189 (1993). https://doi.org/10.1007/BF00315504
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DOI: https://doi.org/10.1007/BF00315504