van der Wall E E, Cats V M, Chin J C, Pauwels E J, Bruschke A V
Department of Cardiology, University Hospital, Leidin, The Netherlands.
Cardiovasc Drugs Ther. 1994 May;8 Suppl 2:345-51. doi: 10.1007/BF00877319.
Nisoldipine is a calcium antagonist with potent coronary vasodilating effects in patients with chronic stable angina pectoris. In an initial study we showed that intravenous nisoldipine, given 24-72 hours after uncomplicated myocardial infarction, was a safe and feasible intervention that had beneficial effects on global and regional myocardial function. We subsequently studied the acute effects of nisoldipine in six patients within 24 hours (mean 14 +/- 4 hours) after the onset of myocardial infarction. Nisoldipine was administered as a 4.5 micrograms/kg intravenous bolus over 3 minutes, followed by intravenous infusion of 0.2 microgram/kg over 60 minutes. Radionuclide angiography, cardiac output, and intraarterial blood pressure measurements were performed before and during nisoldipine. Left ventricular ejection fraction increased from 48.3 +/- 10.3% to 55.3 +/- 11.8% (p = 0.034) during nisoldipine infusion. Regional wall motion score changed during nisoldipine infusion from 3.3 +/- 2.5 to 1.8 +/- 2.6 (p = 0.027). Cardiac output increased from 5.5 +/- 1.0 to 7.3 +/- 1.3 l/min (p = 0.0001). Heart rate increased from 78 +/- 12 to 88 +/- 11 min-1 (p = 0.004). Mean arterial blood pressure decreased from 92 +/- 20 to 79 +/- 13 mmHg (p = 0.038). The rate-pressure product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine improves global and regional left ventricular function in patients with acute myocardial infarction within the first 24 hours.
尼索地平是一种钙拮抗剂，对慢性稳定型心绞痛患者具有强大的冠状动脉舒张作用。在一项初步研究中，我们表明，在无并发症的心肌梗死后24 - 72小时给予静脉注射尼索地平，是一种安全可行的干预措施，对整体和局部心肌功能有有益影响。随后，我们研究了尼索地平在心肌梗死发作后24小时内（平均14±4小时）对6例患者的急性影响。尼索地平以4.5微克/千克的剂量在3分钟内静脉推注，随后在60分钟内以0.2微克/千克的剂量静脉输注。在给予尼索地平之前和期间进行放射性核素血管造影、心输出量和动脉内血压测量。在输注尼索地平期间，左心室射血分数从48.3±10.3%增加到55.3±11.8%（p = 0.034）。在输注尼索地平期间，局部室壁运动评分从3.3±2.5变为1.8±2.6（p = 0.027）。心输出量从5.5±1.0升/分钟增加到7.3±1.3升/分钟（p = 0.0001）。心率从78±12次/分钟增加到88±11次/分钟（p = 0.004）。平均动脉血压从92±20毫米汞柱降至79±13毫米汞柱（p = 0.038）。在输注尼索地平期间，心率与血压乘积没有显著变化。结论是，尼索地平可改善急性心肌梗死患者在发病后24小时内的整体和局部左心室功能。
