Burger W, Herholz H, Burger K, Kober G
Department of Cardiology, University Hospital Frankfurt, F.R.G.
J Cardiovasc Pharmacol. 1990 Nov;16(5):764-8. doi: 10.1097/00005344-199011000-00011.
In a double-blind cross-over study, 10 patients with stable angina pectoris owing to coronary heart disease were investigated in supine position during rest and bicycle exercise for the effect of 0.4 mg of intravenous (i.v.) isradipine in comparison to 2 mg i.v. nifedipine on cardiac hemodynamics and myocardial ischemia. At rest, both drugs significantly decreased total peripheral resistance (TPR) and mean arterial blood pressure (MAP), whereas heart rate (HR) increased. The pressures and resistance of the pulmonary circulation remained uninfluenced at rest. During symptom limited-exercise, both medications reduced TPR despite an unchanged MAP. Mean pulmonary artery pressure decreased significantly after both medications, whereas right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR) decreased significantly only after nifedipine. The improvement of mean ischemic ST-segment depression averaged 44 +/- 6% (mean +/- SEM, p less than or equal to 0.01) after nifedipine and 45 +/- 7% (p less than or equal to 0.01) after isradipine. The time until angina appeared increased after isradipine by 89 +/- 28% (p less than or equal to 0.05) and after nifedipine by 105 +/- 42% (p less than or equal to 0.01). Significant differences between the two medications appeared only for cardiac output (CO) at rest (p less than or equal to 0.05), during which state the increase after isradipine was higher than after nifedipine, and for exercise HR (p less than or equal to 0.01), during which state only nifedipine induced a significant increase in frequency. We conclude that at the chosen dosages the hemodynamic and antiischemic effects of isradipine are similar to the effects that occur after nifedipine.
在一项双盲交叉研究中，对10例因冠心病导致稳定型心绞痛的患者进行了研究，在静息卧位及自行车运动状态下，比较静脉注射0.4mg伊拉地平与2mg硝苯地平对心脏血流动力学及心肌缺血的影响。静息时，两种药物均显著降低总外周阻力（TPR）和平均动脉血压（MAP），而心率（HR）增加。静息时肺循环的压力和阻力未受影响。在症状限制性运动期间，两种药物尽管MAP未改变，但均降低了TPR。两种药物后平均肺动脉压均显著降低，而仅硝苯地平后右心房压（RAP）、肺毛细血管楔压（PCWP）和肺血管阻力（PVR）显著降低。硝苯地平后平均缺血性ST段压低的改善平均为44±6%（均值±标准误，p≤0.01），伊拉地平后为45±7%（p≤0.01）。伊拉地平后心绞痛出现的时间增加了89±28%（p≤0.05），硝苯地平后增加了105±42%（p≤0.01）。两种药物之间的显著差异仅出现在静息时的心输出量（CO）（p≤0.05），此时伊拉地平后的增加高于硝苯地平，以及运动心率（p≤0.01），此时仅硝苯地平导致频率显著增加。我们得出结论，在所选择的剂量下，伊拉地平的血流动力学和抗缺血作用与硝苯地平后的作用相似。
