Hemodynamic Effect of Nifedipine (Adalat) in Patients Catheterized for Coronary Artery Disease

Abstract

Previous investigations on the effect of Adalat on cardio-hemodynamics have shown the following results: There seems to be agreement on the fact that Adalat causes a definite fall in both systolic and diastolic systemic blood pressure. It also increases coronary blood flow, caused by a decrease in coronary resistance. Heart rate was shown to be higher or to remain stable in different studies, after the administration of the drug, as was the cardiac index. As far as contractility parameters are concerned, according to Vater et al. [2] there is primarily an inhibitory action on myocardial contractility. Lichtlen [1] found an increase in peak dp/dt, together with an increase in heart rate and decrease in left ventricular end-dia-stolic pressure. It is not clear, whether these last effects are interrelated, i.e., is the higher peak dp/dt the result of a positive inotropic action of Adalat, independent of a concomitantly higher heart rate, or is it the result of the positive inotropic effect of the higher heart rate itself?