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Coronary vasodilation with dihydropyridines--a pharmacokinetic study.

Abstract
In 26 patients with coronary artery disease, the mean diameters of angiographically 'normal' epicardial coronary arteries were assessed with the aid of a computer-assisted contour detection system (CAAS) before and up to 15 min after onset of a 4-min intravenous-infusion of 2 mg nifedipine (13 patients, group I) or 1 mg nisoldipine (13 patients, group II). Maximal coronary dilation amounted to 20 +/- 9% (4th min) in group I and to 18 +/- 9% (15th min) in group II. In addition, in group II changes of the minimal diameters of 9 coronary obstructions were measured; the maximum increase averaged 28 +/- 15% (7th min). In order to compare the pharmacokinetic properties of these compounds the dilation of the 'normal' coronary segments was correlated with the respective drug plasma levels; maximal plasma concentrations averaged 62 +/- 21 ng ml-1 (7th min) in group I and 17 +/- 7 ng ml-1 (4th min) in group II respectively. A positive, linear correlation between coronary dilation and plasma levels was only found with nifedipine (P less than 0.05); with nisoldipine, however, coronary dilation developed in form of a hysteresis curve, when plotted against plasma levels, probably due to the high receptor affinity of this substance. The prolonged efficacy of nisoldipine could be favourable in oral long-term treatment of patients with coronary artery disease.
AuthorsS Jost, W Rafflenbeul, B Mogwitz, U Nellessen, C Bossaller, P Zwicky, H Hecker, P Lippolt, P R Lichtlen
JournalEuropean heart journal (Eur Heart J) Vol. 10 Suppl F Pg. 147-52 (Nov 1989) ISSN: 0195-668X [Print] England
PMID2620681 (Publication Type: Journal Article)
Chemical References
  • Nisoldipine
  • Nifedipine
Topics
  • Adult
  • Coronary Angiography
  • Coronary Disease (diagnostic imaging, drug therapy, physiopathology)
  • Coronary Vessels (drug effects)
  • Female
  • Hemodynamics (drug effects)
  • Humans
  • Male
  • Middle Aged
  • Nifedipine (blood, pharmacokinetics, therapeutic use)
  • Nisoldipine (blood, pharmacokinetics, therapeutic use)
  • Vasodilation (drug effects)

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