Rocha P, Zannier D, Baron B, Pathe M, David D, Kahn J C
Am J Cardiol. 1987 Apr 1;59(8):775-81. doi: 10.1016/0002-9149(87)91090-3.
Intravenous nicardipine, 5 mg, was infused over 5 minutes in 2 comparable groups of 8 patients with chronic coronary artery disease but no clinical signs of heart failure. Eight patients had received no previous treatment and served as a control group; 8 other patients had received long-term treatment with large doses of propranolol. The hemodynamic responses to nifedipine were similar in the 2 groups, but was greater in patients taking propranolol. At 10 minutes, systemic vascular resistance decreased by 47% in patients taking propranolol and by 39% in the control group; mean aortic pressures decreased by 25% and 10%; heart rate increased by 23% and 19%; and cardiac index increased by 45% in both groups. At 20 minutes, left ventricular end-systolic volume index decreased by 20% in patients taking propranolol and 15% in the control patients; angiographic stroke index increased by 19% and 8%; left ventricular ejection fraction increased by 22% and 11%; and mean circumferential fiber velocity increased by 46% and 32%. Intravenous nicardipine infusion (5 mg) did not induce negative inotropic effects in patients with chronic coronary heart disease, and no evidence of congestive heart failure was seen, even in patients receiving large doses of propranolol. Nicardipine counteracted the potential deleterious effects of propranolol; increased peripheral vascular resistance and left ventricular stroke work and decreased cardiac output.
将5毫克静脉注射尼卡地平在5分钟内输注给两组各8例慢性冠状动脉疾病患者，这些患者均无心力衰竭的临床体征。8例患者此前未接受过治疗，作为对照组；另外8例患者长期接受大剂量普萘洛尔治疗。两组对硝苯地平的血流动力学反应相似，但服用普萘洛尔的患者反应更大。10分钟时，服用普萘洛尔的患者全身血管阻力下降47%，对照组下降39%；平均主动脉压分别下降25%和10%；心率分别增加23%和19%；两组心脏指数均增加45%。20分钟时，服用普萘洛尔的患者左心室收缩末期容积指数下降20%，对照患者下降15%；血管造影卒中指数分别增加19%和8%；左心室射血分数分别增加22%和11%；平均圆周纤维速度分别增加46%和32%。静脉输注尼卡地平（5毫克）对慢性冠心病患者未产生负性肌力作用，即使在接受大剂量普萘洛尔治疗的患者中也未出现充血性心力衰竭的迹象。尼卡地平抵消了普萘洛尔的潜在有害作用；增加外周血管阻力和左心室搏功，降低心输出量。
