Vrolix M C, Sionis D, Piessens J, de Scheerder I, Willems J L, De Geest H
Department of Cardiology, University Hospital of Gasthuisberg, Leuven, Belgium.
J Cardiovasc Pharmacol. 1991 Sep;18(3):342-8. doi: 10.1097/00005344-199109000-00006.
Hemodynamic changes after the subselective intracoronary administration of 50 micrograms of nisoldipine were analyzed in 24 nonstenotic coronary arteries using a randomized, placebo-controlled, double-blind protocol. The following hemodynamic parameters were studied: (a) epicardial coronary artery diameter, assessed by quantitative angiography; (b) coronary blood flow velocity, measured by an intracoronary Doppler probe; (c) coronary blood flow, calculated from the above parameters; (d) coronary flow velocity reserve, assessed after intracoronary administration of 10 mg of papaverine hydrochloride; and (e) heart rate and arterial blood pressure. Since 3 patients were excluded due to unreliable Doppler signals, a total of 21 patients was eligible for complete analysis (placebo: n = 9; nisoldipine: n = 12). In placebo-treated patients, all studied parameters proved to be very stable on repeat measurement and no significant changes were found. In nisoldipine-treated patients, a significant increase in epicardial diameter (+19%; p = 0.0001) and coronary blood flow (+47%; p = 0.003) was found. The coronary blood flow velocity transiently increased after nisoldipine, with a maximum (+80%) after 2 min and returning to baseline within 10 min. Finally, nisoldipine resulted in a significant decrease in the coronary flow velocity reserve by 20% (p = 0.001). All coronary hemodynamic effects were observed in the absence of changes in heart rate and arterial blood pressure. Therefore, the present data demonstrate that nisoldipine acts as a potent dilator of epicardial as well as resistance vessels in nonstenotic human coronary arteries.
采用随机、安慰剂对照、双盲方案，对24条无狭窄的冠状动脉进行亚选择性冠状动脉内注射50微克尼索地平后的血流动力学变化进行了分析。研究了以下血流动力学参数：（a）通过定量血管造影评估的心外膜冠状动脉直径；（b）通过冠状动脉内多普勒探头测量的冠状动脉血流速度；（c）根据上述参数计算的冠状动脉血流量；（d）冠状动脉内注射10毫克盐酸罂粟碱后评估的冠状动脉血流速度储备；以及（e）心率和动脉血压。由于3例患者因多普勒信号不可靠而被排除，共有21例患者符合完整分析条件（安慰剂组：n = 9；尼索地平组：n = 12）。在安慰剂治疗的患者中，所有研究参数在重复测量时都非常稳定，未发现显著变化。在尼索地平治疗的患者中，发现心外膜直径显著增加（+19%；p = 0.0001）和冠状动脉血流量显著增加（+47%；p = 0.003）。尼索地平注射后冠状动脉血流速度短暂增加，2分钟时达到最大值（+80%），并在10分钟内恢复到基线水平。最后，尼索地平导致冠状动脉血流速度储备显著降低20%（p = 0.001）。所有冠状动脉血流动力学效应均在心率和动脉血压无变化的情况下观察到。因此，目前的数据表明，尼索地平在无狭窄的人类冠状动脉中可作为心外膜血管及阻力血管的强效扩张剂。
