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  • Title: Dilatation of epicardial coronary arteries and attenuation of provoked coronary vasoconstriction by nisoldipine.
    Author: Gansser RE, Bachmann KF.
    Journal: Eur Heart J; 1989 Nov; 10 Suppl F():119-26. PubMed ID: 2620679.
    Abstract:
    By using quantitative coronary angiography, this study evaluated the coronary artery dilative action of intravenous nisoldipine and furthermore examined the efficacy of the agent to prevent an ergonovine-provoked increase in the coronary arterial tone. Ten patients suspected of either vasospastic or mixed form of angina pectoris underwent coronary angiography under resting conditions, after 3 micrograms kg-1 of intravenous nisoldipine and finally after a cumulative dose of 0.7 mg of ergonovine maleate. The ergonovine-provocation was performed subsequent to a second intravenous administration of 3 micrograms kg-1 nisoldipine. Coronary artery diameters were measured in angiographically normal, proximal segments by using a computer assisted procedure with automatic contour detection. The following results are given as the mean +/- SEM of the percentage changes in the diameters of 30 coronary artery segments. Nisoldipine produced dilatation of the epicardial coronary arteries with a mean increase in the diameters by 9.5 +/- 1.3% with respect to baseline (P less than 0.01). Subsequent ergonovine-testing caused coronary artery vasoconstriction with a mean diameter decrease of 7.7 +/- 1.3% below baseline (P less than 0.01). Though nisoldipine did not totally block the ergonovine-induced increase in the coronary vasomotor tone, there was a significant attenuation of the coronary constriction compared with patients without any premedication (7.7 +/- 1.3% versus 13.6 +/- 0.6%, P less than 0.01). The ability of nisoldipine to dilate epicardial coronary arteries but also to reduce a provoked coronary artery constriction promises therapeutic effectiveness for both the prevention and release of angina pectoris caused by an increased coronary vasomotor tone.
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