Authors: KELBÆK, HENNING; ALDERSHVILE, JAN; SKAGEN, KNUD; HILDEBRANDT, PER; NIELSEN, STEEN L.

Source: British Journal of Clinical Pharmacology, Volume 41, Number 6, June 1996 , pp. 493-497(5)

Publisher: Wiley-Blackwell

Abstract:

1The acute effect and effect of 14 days' treatment with isosorbide dinitrate (ISDN) and nifedipine (NIF) was evaluated by radionuclide cardiography in patients with chronic mitral regurgitation and sinus rhythm.

2In 23 patients with clinically stable disease blood pressure was lowered by 15% and left ventricular volume was reduced by 16-20% after 20 mg sublingual ISDN causing combined pre-and afterload reduction. Afterload reduction alone induced by 10 mg NIF resulted in an acute 9% decrease in left ventricular endsystolic volume, whereas forward stroke volume increased by 30%, and regurgitation fraction tended to decrease. No haemodynamic effects could be detected after 14 days' treatment with 20 mg ISDN orally twice daily (preload reduction), whereas 20 mg NIF twice daily (afterload reduction) caused an increase in forward stroke volume (18%) and a decrease in both regurgitant volume (20%) and regurgitation fraction (22%) without affecting blood pressure or heart rate.

3ISDN and NIF have beneficial acute haemodynamic effects in patients with chronic mitral regurgitation probably due to their pre- and afterload reducing properties. The reduction in regurgitation induced by NIF appears to be sustained after 14 days therapy.

Keywords: mitral regurgitation; radionuclide cardiography; isosorbide; dinitrate; nifedipine

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1365-2125.1996.03363.x

Affiliations: 1: Medical Department B, Rigshospitalet, Department of Cardiology and Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Department of Cardiology, Gentofte Hospital, University of Copenhagen, Denmark

Publication date: 1996-06-01

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