Acute Hemodynamic Effects of Intravenous Nisoldipine in Patients with Left Ventricular Failure

Summary

The acute hemodynamic effects of intravenous nisoldipine were studied during cardiac catheterization in ten patients (age 31–69 years, mean 54 years) with left ventricularfailure. At rest, the mean cardiac index (CI) was 2.0 liter min⁻¹m⁻², the left ventricular end diastolic pressure (□ EDP) 28 mmHg, and the ejection fraction (EF) 32%. Nisoldipine was administered intravenously at a dose of 3 µg/kg over 3 min. Hemodynamic parameters were controlled 1 min after the end of the infusion. Whereas a small but significant (P < 0.009) increase of heart rate was recorded (mean: 87vs 91), the more striking changes were a marked increase of CI (2.0vs 2.8, P < 0.001) and a fall of systemic vascular resistance (1950 vs 1165, P < 0.001). There was a concomitant fall of aortic pressures (mean: 93 vs 80, P < 0.001). The EF was improved (32 vs 37, P < 0.009). Other parameters such as LVEDP, pulmonary wedge and pulmonary artery pressures, max dp/dt, and LV diastolic volume index did not show significant changes.

The overall results are consistent with the powerful peripheral vasodilative effect of nisoldipine. By decreasing afterload, it may thus have helpful effects on left ventricular function in patients with left ventricular failure.