ASSESSMENT OF LEFT-VENTRICULAR FUNCTION AFTER SUBLINGUAL ADMINISTRATION OF NIFEDIPINE IN PATIENTS WITH MODERATE TO SEVERE HYPERTENSION

被引：4

作者：

HAYASHI, H

IWASE, M

AOKI, T

YOKOTA, M

机构：

[1] First Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, 466, 65 Tsurumai, Showa-ku

来源：

CARDIOVASCULAR DRUGS AND THERAPY | 1990年 / 4卷

关键词：

LV FUNCTION; HYPERTENSION; AFTERLOAD REDUCTION; PRELOAD REDUCTION;

D O I：

10.1007/BF02018302

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

To evaluate the left ventricular functional changes induced by acute decreases in blood pressure in 15 patients with systemic hypertension and left ventricular hypertrophy, this study used Doppler and M-mode echocardiographic derived left ventricular indices. After 30 minutes of administration of sublingual nifedipine, both systolic and diastolic blood pressure decreased and heart rates increased. The left ventricular end-systolic dimension decreased but not the end-diastolic dimension, which suggests that sublingual nifedipine may decrease only afterload, not preload. Total peripheral resistance decreased from 2770 to 1960 dyne.sec.cm-5. The M-mode-derived peak rate of dimension changes improved both the systolic and diastolic phase, and Doppler-derived indices of atrial contribution to ventricular filling decreased. Because both the systolic and diastolic phase indices of LV function are sensitive to variations in both preload and afterload, the improvement of myocardial contractility per se cannot necessarily be attributed to the direct effect of the drug to myocardium. Though favorable effects on the myocardial oxygen supply-demand ratio or increased adrenergic tone stimulated by the decline in systemic arterial pressures may contribute to the augmentation of LV systolic and diastolic function observed after nifedipine in the present study, the apparent augmentation of LV function appears to be attributable primarily to afterload reduction.

引用

页码：969 / 976

页数：8

共 15 条

[1]

Ludbrook P.A., Tiefenbrum A.J., Reed F.R., Sobel B.E., Acute hemodynamic responses to sublingual nifedipine: Dependence on left ventricular function, Circulation, 65, pp. 489-497, (1982)

[2]

Sahn D.J., DeMaria A., Kisslo J., Weyman A., The Committee on M-mode Standardization of the American Society of Echocardiography. Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements, Circulation, 58, pp. 1072-1083, (1978)

[3]

Teichholz L.E., Kreulen T., Herman M., Gorlin R., Problems in echocardiographic volume determinations: Echocardiographic-angiographic correlations in the presence or absence of asynergy, Am J Cardiol, 37, pp. 7-14, (1976)

[4]

Papademetriou V., Gottdiener J.S., Fletcher R.D., Freis E.D., Echocardiographic assessment by computer-assisted analysis of diastolic left ventricular function and hypertrophy in borderline or mild systemic hypertension, Am J Cardiol, 37, pp. 7-11, (1985)

[5]

Snider R.A., Gidding S.S., Rocchini A.P., Et al., Doppler evaluation of left ventricular diastolic filling in children with systemic hypertension, Am J Cardiol, 56, pp. 921-926, (1985)

[6]

Klein W., Brandt D., Vrecko K., Harringer M., Role of calcium antagonists in the treatment of essential hypertension, Circ Res, 52, pp. 174-181, (1983)

[7]

Massie B.M., Hirsch A.T., Inouye I.K., Tubau J.F., Calcium channel blockers as antihypertensive agents, Am J Med, 77, pp. 135-142, (1984)

[8]

Kurnik P.B., Tiefenbrum A.J., Ludbrook P.A., The dependence of the cardiac effects of nifedipine on the responses of the peripheral vascular system, Circulation, 69, pp. 963-972, (1984)

[9]

Kurnik P.B., Courtois, Ludbrook P.A., Effects of nifedipine on intrinsic myocardial stiffness in man, Circulation, 74, pp. 126-134, (1986)

[10]

Ishida Y., Meisner J., Tsujioka K., Et al., Left ventricular filing dynamics: Influence of left ventricular relaxation and left atrial pressure, Circulation, 74, pp. 187-196, (1986)

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