Effects of nicardipine on regional diastolic left ventricular function in patients with angina pectoris.

Hanet, Claude [UCL] Rousseau, Michel [UCL] van Eyll, Christian [UCL] Pouleur, H.

The effects of the slow calcium channel blocker nicardipine on the synchrony of left ventricular filling were examined in eight patients with angina pectoris. Left ventriculography was performed at baseline (after pretreatment with propranolol to minimize reflex changes) and was repeated after the intravenous administration of 2.5 mg nicardipine. Regional peak filling rate and time to peak filling rate were determined in eight ventricular segments before and after nicardipine. At baseline, the time from the R wave to the regional peak filling rate was 380-680 msec, and there were a large number of segments with depressed peak filling rate (p less than 0.001, vs. distribution of regional peak filling rate in normal subjects using a Kolmogorov-Smirnov test), indicating both asynchrony of filling (p less than 0.001, vs. distribution of time to peak filling rate in normal subjects) and nonhomogeneity of diastolic distensibility. Nicardipine administration significantly reduced the distribution of the time to peak filling rate (p less than 0.001) and increased regional peak filling rate (p less than 0.001) in a large subset of segments. Segments with normal values of peak filling rate at baseline, however, frequently did not improve or even decreased their peak filling rate. The changes in global left ventricular filling rate after drug administration also correlated with the number of segments improved after nicardipine. It is concluded that intravenous nicardipine improves the synchrony of diastolic filling in patients with angina pectoris.(ABSTRACT TRUNCATED AT 250 WORDS)