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Titolo:
Effects of nifedipine on myocardial blood flow and systolic function in humans with ischemic heart disease
Autore:
Zervos, G; Zusman, RM; Swindle, LA; Alpert, NM; Fischman, AJ; Gewirtz, H;
Indirizzi:
Harvardn,niv, Sch Med, Massachusetts Gen Hosp, Dept Med,Cardiac Unit, Bosto Harvard Univ Boston MA USA 02114 s Gen Hosp, Dept Med,Cardiac Unit, Bosto Harvard4Univ, Sch Med, Massachusetts Gen Hosp, Dept Radiol, Boston, MA 0211 Harvard Univ Boston MA USA 02114 s Gen Hosp, Dept Radiol, Boston, MA 0211 Harvard114iv, Sch Med, Massachusetts Gen Hosp, Dept Nucl Med, Boston, MA 02 Harvard Univ Boston MA USA 02114 s Gen Hosp, Dept Nucl Med, Boston, MA 02
Titolo Testata:
CORONARY ARTERY DISEASE
fascicolo: 3, volume: 10, anno: 1999,
pagine: 185 - 194
SICI:
0954-6928(199905)10:3<185:EONOMB>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; DOMESTIC SWINE; CLOSED-CHEST; N-13 AMMONIA; DOUBLE-BLIND; EXERCISE; DOGS; PERFUSION; INFARCTION; QUANTIFICATION;
Keywords:
nifedipine; myocardial blood flow; ischemic heart disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Gewirtz, H Harvardntniv, Sch Med, Massachusetts Gen Hosp, Dept Med,CardiacUnit, Vince Harvard Univ Vincent Burnham 3 Boston MA USA 02114 Unit, Vince
Citazione:
G. Zervos et al., "Effects of nifedipine on myocardial blood flow and systolic function in humans with ischemic heart disease", CORON ART D, 10(3), 1999, pp. 185-194

Abstract

Objective To test the hypothesis that, in humans with ischemic heart disease, nifedipine is a primary dilator of the coronary circulation and in general exerts a net positive effect on the balance of myocardial oxygen supplyand demand. Methods Positron-emission tomography with [N-13]-ammonia was used to measure myocardial blood flow in patients at rest, and during infusion of adenosine and ingestion of nifedipine (10 mg capsule, a bite-and-chew technique). Myocardial segments were defined physiologically on the basis of blood flow to adenosine as being normal or having mild, moderate, or severe impairment of dilator reserve. Myocardial systolic function was assessed under comparable physiologic conditions using gated single-photon-emission computed tomography radionuclide ventriculography. Results Our study population consisted of 13 male patients and one female patient. Ingestion of nifedipine increased heart rate (from 63 +/- 1 1 to 80 +/- 16 beats/min, P<0.001) and, as intended, lowered systolic arterial pressure (from 148 +/- 20 to 123 +/- 14 mmHg, P < 0.001) but had no effect onheart rate-pressure product (which changed from 9283 +/- 1576 to 9942 +/- 2162 mmHg/min). Myocardial blood flow in patients at rest in segments with mild, moderate, and severe reductions of dilator capacity (0.63 +/- 0.20, 0.67 +/- 0.25, and 0.58 +/- 0.27 ml/min per g, respectively) was less (P<0.01) than normal (0.91 +/- 0.29 ml/min per g). Nevertheless, flow of blood was increased versus that at rest (P< 0.01) by infusion of adenosine (to 1.78+/- 0.13, 1.29 +/- 0.16, and 0.75 +/- 0.22 ml/min per g) and ingestion of nifedipine (to 1.17 +/-0.51, 1.06 +/- 0.36, 0.85 +/- 0.42 ml/min per g) in segments with mild, moderate, and severe reductions of dilator capacity as well as in normal segments (to 3.18 +/- 0.85 ml/min per g with adenosine and 1.68 +/- 0.65 ml/min per g with nifedipine). Global left ventricular systolic function remained unchanged versus baseline (ejection fraction 0.74 +/- 0.09) with nifedipine (0.78 +/- 0.10). Regional contraction expressed in normalized amplitude units also remained unchanged versus baseline in response to nifedipine. Conclusion Nifedipine increases myocardial blood flow in humans with ischemic heart disease in normal segments as well as in segments with mild, moderate, and severe reductions of dilator capacity, albeit to a lesser extent with increasing impairment of dilator capacity. Both global and regional left ventricular contractile function also are not adversely affected by nifedipine. These improvements in myocardial blood flow in face of no change ora decrease in myocardial demand for oxygen reflect an overall favorable effect on the balance between the supply of and demand for myocardial oxygen. Coronary Artery Dis 10:185-194 (C) 1999 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 11:47:55