Ram J, Freedman S B, Ogasawara S, Thomson A, Kelly D T
Hallstrom Institute of Cardiology, University of Sydney, Royal Prince Alfred Hospital, Australia.
Am J Cardiol. 1989 Apr 1;63(12):802-6. doi: 10.1016/0002-9149(89)90046-5.
The acute effects of 10 mg of oral nisoldipine on hemodynamics, oxygen transport and metabolism, and distribution of cardiac output, at rest and during semiupright bicycle exercise, were evaluated in 10 men with effort angina receiving long-term beta 1 blockade. Cardiac output and leg blood flow were measured using the thermodilution technique. At rest, nisoldipine decreased systemic resistance from 18.9 +/- 1.0 to 15.9 +/- 1.2 dynes.s.cm-5.10(2) (p less than 0.05) and cardiac output increased from 4.8 +/- 0.2 to 5.3 +/- 0.3 liters/min (p less than 0.05) without changing leg blood flow. During maximal exercise with nisoldipine, systemic resistance was reduced (10.6 +/- 0.9 to 8.6 +/- 0.5 dynes.s.cm-5.10(2), p less than 0.05) and cardiac output increased 18% (10.3 +/- 0.7 to 12.2 +/- 0.6 liters/min, p less than 0.05) when compared with control values. Exercise heart rate was higher with nisoldipine (113 +/- 4 vs 106 +/- 4 beats/min, p less than 0.01), but the mean arterial pressure was not significantly changed, giving a higher rate-pressure product. The increase in mean pulmonary artery wedge pressure was attenuated (26 +/- 3 vs 30 +/- 3 mm Hg during control exercise, p less than 0.05), but ST depression was unaltered. Exercise leg flow was reduced by nisoldipine from 4.3 +/- 0.4 to 3.9 +/- 0.3 liters/min (p = 0.07) and the proportion of cardiac output distributed to the legs was reduced from 42 +/- 3 to 33 +/- 3% (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
在10名接受长期β1受体阻滞剂治疗的劳力型心绞痛男性患者中，评估了口服10毫克尼索地平对静息状态及半直立位自行车运动时血流动力学、氧运输与代谢以及心输出量分布的急性影响。采用热稀释技术测量心输出量和腿部血流。静息时，尼索地平使全身阻力从18.9±1.0降至15.9±1.2达因·秒·厘米⁻⁵·10²（p<0.05），心输出量从4.8±0.2升/分钟增加至5.3±0.3升/分钟（p<0.05），而腿部血流未改变。在尼索地平作用下进行最大运动时，全身阻力降低（从10.6±0.9降至8.6±0.5达因·秒·厘米⁻⁵·10²，p<0.05），与对照值相比，心输出量增加18%（从10.3±0.7升至12.2±0.6升/分钟，p<0.05）。服用尼索地平时运动心率较高（113±4对106±4次/分钟，p<0.01），但平均动脉压无显著变化，导致心率-血压乘积升高。平均肺动脉楔压的升高减弱（对照运动时为30±3毫米汞柱，服用尼索地平时为26±3毫米汞柱，p<0.05），但ST段压低未改变。尼索地平使运动时腿部血流从4.3±0.4升/分钟降至3.9±0.3升/分钟（p = 0.07），分配到腿部的心输出量比例从42±3%降至33±3%（p<0.01）。（摘要截选至250字）
