Effects of nicardipine on coronary blood flow left ventricular inotropic state and myocardial metabolism in patients with angina pectoris

摘要

>1 The effects of intravenous nicardipine (2.5 mg) on the left ventricular (LV) inotropic state, LV metabolism, and coronary haemodynamics were analysed in 22 patients with angina pectoris.>2 Measurements were made at fixed heart rate (atrial pacing), under basal state, and during a cold pressor test.>3 After nicardipine, coronary blood flow and oxygen content in the coronary sinus increased significantly.>4 The indices of inotropic state increased slightly, and the rate of isovolumic LV pressure fall improved.>5 Myocardial oxygen consumption was unchanged despite the significant reduction in pressure-rate product, but LV lactate uptake increased, particularly during the cold pressor test.>6 When nicardipine was administered after propranolol, the indices of inotropic state were unaffected.>7 The lack of direct effect of nicardipine on LV inotropic state was further confirmed by intracoronary injection of 0.1 and 0.2 mg in a separate group of 10 patients.>8 It is concluded that the nicardipine-induced coronary dilatation seems to improve perfusion and aerobic metabolism in areas with chronic ischaemia, resulting in reduced lactate production and augmented oxygen consumption.