Wout van den Toren E, de Vries R J, Portegies M C, Blanksma P K, van Gilst W H, Hillege H J, van Veldhuisen D J, Lie K I
Department of Cardiology, University Hospital Groningen, The Netherlands.
J Cardiovasc Pharmacol. 1994 Jun;23(6):952-8. doi: 10.1097/00005344-199406000-00014.
To elucidate the effect of isradipine and nifedipine on left ventricular (LV) systolic and diastolic function, each drug was given intravenously (i.v.) in equihypotensive doses to 10 patients accepted for coronary arteriography for stable angina pectoris. All 20 patients had LV ejection fraction (LVEF) of < 40% owing to previous myocardial infarction (MI). Systolic and diastolic function was assessed by standard hemodynamic parameters and pressure-volume relations measured by nuclear stethoscope. All measurements were taken at rest and during ischemia caused by right atrial pacing. Both systolic and diastolic parameters improved equally with isradipine and nifedipine. LVEF and cardiac output (CO) increased owing to peripheral vasodilatation. A decrease in P/Vmax, indicating a negative inotropic effect, was noted in patients at rest with both medications, but not during pacing-induced ischemia. With either medication, the time constant of relaxation and the end-diastolic elasticity constant decreased during pacing, indicating improvement in diastolic function, probably owing to relief of myocardial ischemia.
为阐明伊拉地平与硝苯地平对左心室（LV）收缩和舒张功能的影响，将每种药物以等降压剂量静脉注射给10例因稳定型心绞痛而接受冠状动脉造影的患者。所有20例患者均因既往心肌梗死（MI）导致左心室射血分数（LVEF）<40%。通过标准血流动力学参数和核听诊器测量的压力-容积关系评估收缩和舒张功能。所有测量均在静息状态和右心房起搏引起的缺血期间进行。伊拉地平和硝苯地平对收缩和舒张参数的改善程度相同。由于外周血管扩张，LVEF和心输出量（CO）增加。两种药物在静息患者中均观察到P/Vmax降低，表明有负性肌力作用，但在起搏诱导的缺血期间未观察到。使用任何一种药物时，起搏期间舒张时间常数和舒张末期弹性常数均降低，表明舒张功能改善，这可能是由于心肌缺血得到缓解。
