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  • Title: [Action of nifedipine on effort tolerance and on the left ventricular function during exercise in patients suffering from angina pectoris (author's transl)].
    Author: Valenti P.
    Journal: G Ital Cardiol; 1980; 10(4):431-9. PubMed ID: 7439584.
    Abstract:
    The therapeutic action of Nifedipine (Ni) and some of its haemodynamic effects have been studied in 24 male patients suffering from chronic, severe angina pectoris (Class II and III according to the NYHA) by means of right heart catheterization and repeated quantitative bicycle ergometer exercise test before and after 10 mg. Ni given orally. After Ni, the total work performance until exercise-induced angina occurred increased from 14.16 +/- 6.8 to 24 +/- 12.8 Kilojoules (+ 85.6%, p < 0.001), while the exercising pulmonary artery wedge pressure decreased from the initial control level of 28.5 +/- 6.7 to 17.86 +/- 4.3 mmHg (p < 0.001), indicating a probably equivalent drop in the left ventricular end-diastolic pressure and hence a clearly improved left ventricular function. The drug produced only a 3.2%, not significant rise in the exercising heart rate and a moderate fall in the exercising humeral artery systolic (-8.6 mmHg, p < 0.001), diastolic (-7.8 mmHg N.S.) and mean (-10, 1 mmHg N.S.) pressures. Most patients considered the second exercise test after Ni as less tiresome, and no relevant side-effects occurred. The mechanisms of this very evident antianginal action of Ni are discussed and it is concluded that this beneficial effect probably occurs by the way of a reduced left ventricular afterload and probably also of an increased or otherwise more efficient oxygen supply to the heart, whereas a depressing action of the myocardial contractility seems excluded.
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