TY - JOUR
T1 - Effect of nicardipine on rest and exercise hemodynamics in chronic congestive heart failure
AU - Ryman, Kathleen S.
AU - Kubo, Spencer H.
AU - Lystash, John
AU - Stone, Gregg
AU - Cody, Robert J.
N1 - Funding Information:
From the Cardiology Division, Department of Medicine, The New York Hospital-Cornell University Medical College, New York, New York. This study was supported in part by a General Clinical Research Center Grant RR-047 from the National Institutes of Health, Bethesda, Maryland, and a grant form the G. Harold and Leila Y. Mathers Charitable Foundation made in memory of Ralph C. Menapace. Additional support and nicardipine were provided by Syntex Inc., Palo Alto, California. Dr. Cody is an Established Fellow of the New York Heart Association. Manuscript received March 31, 1986; revised manuscript received May 12.1986, accepted May 13.1986.
PY - 1986/9/15
Y1 - 1986/9/15
N2 - The hemodynamic response to vasodilation induced by the new calcium channel antagonist nicardipine was studied in 10 patients with severe, chronic congestive heart failure. Rest and exercise hemodynamics were evaluated in the baseline state and after 1 week of oral nicardipine therapy (30 mg 3 times daily). In addition, respiratory gas exchange and arteriovenous oxygen difference were measured to assess changes in oxygen utilization. The responses of the sympathetic nervous system were evaluated by measuring plasma norepinephrine concentrations at rest and during maximal exercise. At rest, nicardipine administration was associated with significant reductions in mean systemic arterial pressure, systemic vascular resistance, pulmonary artery wedge pressure and pulmonary arterial pressure, and significant increases in cardiac index and stroke volume index. These effects were maintained during exercise. In contrast to findings with other calcium channel antagonists, no negative inotropic effect of nicardipine was identified. Nicardipine administration was associated with reduction of arteriovenous oxygen difference. Nicardipine had no effect on plasma norepinephrine concentrations, suggesting absence of reflex sympathetic nervous activation. Thus, nicardipine-mediated vasodilation leads to significant improvements in both rest and exercise cardiac performance.
AB - The hemodynamic response to vasodilation induced by the new calcium channel antagonist nicardipine was studied in 10 patients with severe, chronic congestive heart failure. Rest and exercise hemodynamics were evaluated in the baseline state and after 1 week of oral nicardipine therapy (30 mg 3 times daily). In addition, respiratory gas exchange and arteriovenous oxygen difference were measured to assess changes in oxygen utilization. The responses of the sympathetic nervous system were evaluated by measuring plasma norepinephrine concentrations at rest and during maximal exercise. At rest, nicardipine administration was associated with significant reductions in mean systemic arterial pressure, systemic vascular resistance, pulmonary artery wedge pressure and pulmonary arterial pressure, and significant increases in cardiac index and stroke volume index. These effects were maintained during exercise. In contrast to findings with other calcium channel antagonists, no negative inotropic effect of nicardipine was identified. Nicardipine administration was associated with reduction of arteriovenous oxygen difference. Nicardipine had no effect on plasma norepinephrine concentrations, suggesting absence of reflex sympathetic nervous activation. Thus, nicardipine-mediated vasodilation leads to significant improvements in both rest and exercise cardiac performance.
UR - http://www.scopus.com/inward/record.url?scp=0022492879&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(86)90280-8
DO - 10.1016/0002-9149(86)90280-8
M3 - Article
C2 - 3751928
AN - SCOPUS:0022492879
SN - 0002-9149
VL - 58
SP - 583
EP - 588
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 7
ER -