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ABSTRACT: The first "selective" coronary arteriogram was made 50 years ago by Dr. F. Mason Sones at the Cleveland Clinic. Soon afterward coronary arteriography was developed as a diagnostic method suitable for widespread clinical application. This method has revolutionized our understanding of coronary artery disease and has become the basis for selecting and evaluating therapeutic interventions. This Viewpoint commemorates the achievements of the pioneers of coronary arteriography, the difficulties they encountered, and their impact on the development of modern cardiology. Developments during the last half century and prospects for the future are discussed in historical perspective.
Journal of the American College of Cardiology 12/2009; 54(23):2139-44. · 14.16 Impact Factor
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Journal of the American College of Cardiology 10/2008; 52(11):921-3. · 14.16 Impact Factor
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ABSTRACT: Magnetic resonance images were obtained from 32 patients with acute myocardial infarction, using a four-echo technique (echo time (TE) = 30, 60, 90, and 120 ms) pre-gadolinium(Gd)-DTPA injection and a TE = 30 ms sequence pre- and post-Gd-DTPA. Intensity ratios of infarcted and normal myocardium were calculated, as were contrast-to-noise and signal-to-noise ratios. The four intensity ratios pre-Gd-DTPA were 1.20 ±0.15, 1.42 ± 0.22, 1.78 ± 0.38, and 1.99 ± 0.60 for TE = 30, 60, 90, and 120 ms, respectively, and 1.42 ± 0.19 post-Gd-DTPA (p = NS for post-Gd-DTPA vs TE = 60, p = 0.007 for TE = 90 vs TE = 120, p < 0.0001 for all other comparisons). The four contrast-to-noise ratios pre-Gd-DTPA were 1.69 ± 0.97, 2.69 ± 1.13, 3.17 ± 1.15, and 2.90 ± 1.09 for TE = 30, 60, 90, and 120 ms, respectively, and 2.71 ± 1.26 post-Gd-DTPA (p = NS for post-Gd-DTPA vs TE = 60, 90, and 120, p = NS for TE = 120 vs TE = 60 and 90, p< 0.01 for all other comparisons). The four signal-to-noise ratios pre-Gd-DTPA were 8.67 ± 1.47, 6.52 ± 0.76, 5.20 ± 0.64, 4.17 ± 0.53 for TE = 30, 60, 90, and 120 ms, respectively, and 9.17 ± 1.92 post-Gd-DTPA (p = 0.03 for post-Gd-DTPA vs TE = 30, p < 0.0001 for all other comparisons). In conclusion, the detectabilities of acute myocardial infarction were similar at TE = 60 ms and at Gd-DTPA enhanced short-TE MR imaging. However, image quality proved to be superior using the Gd-DTPA enhanced short-TE technique. © 1991 Academic Press, Inc.
Magnetic Resonance in Medicine 11/2005; 17(2):460 - 469. · 2.96 Impact Factor
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ABSTRACT: Oxidation susceptibility of lipids in vitro is considered to reflect the exposure of lipids to oxidation stress in vivo which is related to cardiovascular morbidity. This study examined the effect of pravastatin therapy on serum oxidation susceptibility, particularly in relation to endothelial function of coronary arteries.
The participants were recruited from the Pravastatin-Related Effects Following Angioplasty on Coronary Endothelium trial, a double-blinded, placebo-controlled, randomized, multi-center study designed to analyze the effect of pravastatin treatment on endothelial function in previously dilated and normal coronary arteries. Serial, graded, intra-coronary acetylcholine infusions were used to assess endothelial function. In vitro, copper-induced, serum oxidation parameters were determined at randomization and at time of coronary endothelial function assessment.
Oxidation parameters were determined in 45 patients (pravastatin 23, placebo 22). Pravastatin therapy significantly improved serum oxidation lag time (+8%, P<0.05), maximal diene formation rate (-22%, P<0.01) and total amount of dienes formed after 5 h (-16%, P<0.01). These parameters remained essentially unchanged in the placebo group. Acetylcholine-evoked responses were positively correlated to therapy-induced change in serum oxidation susceptibility in the dilated segment group (r2=0.56, P=0.006).
Pravastatin's beneficial effect on endothelial dysfunction of dilated coronary segments may be secondary to pravastatin's improvement of oxidation susceptibility.
Atherosclerosis 08/2003; 169(2):309-15. · 3.79 Impact Factor
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ABSTRACT: Various combinations of sympathetic and vagal tone can yield the same heart rate, while ventricular electrophysiology differs. To demonstrate this in humans, we studied healthy volunteers in the sitting position with horizontal legs. First, heart rate was increased by lowering the legs to 60 and back. Thereafter, heart rate was increased by handgrip. In each subject, a leg-lowering angle was selected at which heart rate matched best with heart rate in the third handgrip minute. Thirteen subjects had a heart rate match better than 1%. Heart rate (control: 65.2Nj.0 bpm) increased to 72.1NJ.7 (leg lowering) and to 72.1NJ.8 (handgrip) bpm. QRS azimuth, QRS duration, maximal T vector, T azimuth, T elevation, ST duration, QRS-T angle and QT interval differed significantly (P<0.05) between leg lowering and handgrip (QT interval 418ᆣ versus 435ᆩ ms). Also, septal dispersion of repolarization, assessed as the time difference between the apex and the end of the T wave in the V2 and V3 leads, differed significantly (V2: 96.7ᆧ.3 versus 110.0ᆫ.3 ms, P<0.01; V3: 88.7ᆧ.3 versus 97.3ᆫ.3 ms; P<0.01). Hence, leg lowering and handgrip cause different ventricular depolarization and repolarization. The hypertensive handgrip manoeuvre entails a longer QT interval and probably an increased septal dispersion of repolarization.
Pflügers Archiv - European Journal of Physiology 01/2001; 441(5):717-724. · 4.46 Impact Factor
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ABSTRACT: A sinus of Valsalva aneurysm is an uncommon congenital defect, which requires appropriate diagnosis with either echocardiography, magnetic resonance imaging or contrast angiography. Treatment consists of aortic valve repair. We describe a young woman with an aneurysm of the non-coronary sinus of Valsalva, an atrial septal defect and pulmonary insufficiency. The different imaging techniques and possibilities of surgical correction are described.
International Journal of Cardiac Imaging 01/2000; 16(1):35-41.
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ABSTRACT: Micro stent™ (MS) is a radiopaque stainless steel balloon expandable intracoronary stent. The stent is mounted on a rapid-exchange delivery system. From August 1994–March 1995, 127 MS were implanted in 85 patients (pts, 1.5 stents/pt, 85 in native vessels and 42 in bypass vein grafts, 61 male and 24 female, age 33–77 yr, mean age 61 ± 10 yr). Pts studied were scheduled for either elective PTCA (n = 62, 73%) or PTCA for acute myocardial infarction (n = 23, 27%). Elective stent implantation was performed in 45 pts (53%). An MS was implanted because of a suboptimal balloon angioplasty result in 26 pts (31%). The stent was implanted because of threatened or acute vessel closure after balloon angioplasty in 14 pts (16%). During the procedure, 500 mg aspirin and 2 × 7,500 units of heparin were administered intravenously, followed by systemic heparinization for 48 hr. Pts were discharged with 100 mg aspirin daily (n = 50, 59%), or anticoagulant drugs and 100 mg aspirin daily (n = 19, 22%), or anticoagulant drugs only (n = 16, 19%). Angiographic results were analyzed with computer-assisted quantitative coronary arteriography. Angiographic success (defined as a residual stenosis of <30%) was achieved in 124 of 127 attempts (98%). The mean minimal luminal diameter of the target lesions increased from 0.88 ± 0.79 mm before stent implantation to 3.08 ± 0.56 mm (P < 0.001). The percentage of diameter stenosis was reduced from 77.9 ± 20.9% before to 13.3 ± 10.5% (P < 0.001) after stent implantation. The average initial gain was 2.53 ± 1.37 mm. The procedural success rate (defined as a residual stenosis of <30% without occurrence of major clinical events within 3 wk after procedure) was 84%. Major clinical events included: death 1 pt (1%); cerebrovascular accident, 1 pt (1%); subacute stent closure, 5 pts (6%); coronary artery bypass grafting, 3 pts (4%); false femoral aneurysm, 2 pts (2%). The initial results of Micro stent implantations are promising. No anticoagulant therapy was given to most of the patients (59%). Few vascular and bleeding complications were observed. However, at this stage, no data about the restenosis rate after implantation of a Micro stent are available. © 1996 Wiley-Liss, Inc.
Catheterization and Cardiovascular Diagnosis 12/1998; 38(2):135 - 143.
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ABSTRACT: The Micro stentTM (MS) is a balloon expandable stent that allows the treatment of stenoses in distal and tortuous coronary arteries. This prospective study was performed to evaluate initial and late results of MS implantations. A total of 127 MS (101 in native coronary arteries and 26 in saphenous vein grafts) were implanted in 85 patients (1.5 stents/pt, 65 male, and 20 female, age 62, ±10 yr) with angina pectoris class II-III: 21 (25%), angina pectoris class IV: 41(48%), and acute myocardial infarction: 23 (27%). Indications per segment treated (n=93): elective: 49 (53%); suboptimal balloon angioplasty (PTCA) result: 33(35%); bailout: 11 (12%). The patients were discharged with 100 mg of aspirin daily unless other indications for oral anticoagulants were present. Procedural success (diameter stenosis of 30% without the occurrence of clinical events within 3 wk) was 85%. Early clinical events (<3 wk included: death:1%; subacute closure: 5%; coronary artery bypass surgery (CABG): 1%; vascular complications: 4%. Late clinical events (3 wk-6 mo) included: acute myocardial infarction:3%, PTCA 5%, CABG 3%, angina class III-IV: 4%. Quantitative angiographic results were: the minimum lumen diameter increased from 0.90 ± 0.72 before to 3.05 ± 0.48 mm (<P0.001) after stent implantation. At follow-up, which was 5.5 mo ± 1.1 mo, 61/79 pts (77%), the loss in diameter was 0.90 ± 0.68 mm. The net gain was 1.26 ± 0.90 mm. The restenosis rate (diameter stenosis > 50% at FU) was 13%. This study demonstrates high procedural and late success rates of Micro stent implantations. Cathet. Cardiovasc. Diagn. 43:19-27, 1998. © 1998 Wiley-Liss, Inc.
Catheterization and Cardiovascular Diagnosis 12/1998; 43(1):19 - 27.
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ABSTRACT: Lipid-lowering therapy now has undoubtedly proven to be an effective therapeutic modality to retard the progression of coronary atherosclerosis. An additional approach for prevention of the progression of atherosclerosis is calcium channel blocker (CCB) treatment. Evidence indicating that CCBs inhibit atherosclerosis is less unequivocal than the clear evidence for lipid-lowering therapy. Many investigations support the view that a number of key processes in atherosclerosis may be influenced by CCBs. From the negative and positive studies with CCBs performed in animals and humans we must conclude that apparently some, but not all, types or stages of the atherosclerotic process are inhibited by CCBs. To assess whether lipid-lowering therapy and CCB treatment may have an additive or synergistic beneficial effect on human atherosclerosis, which is conceivable because their anti-atherosclerotic properties differ, data from the angiographic lipid-lowering trial REGRESS (pravastatin vs. placebo) were reviewed. In REGRESS, patients in the pravastatin group had significantly less progression if cotreated with CCBs as compared with those with no CCB cotreatment, whereas in the placebo (no pravastatin) group no effect of CCB treatment was observed. With respect to angiographic new lesion formation, in the pravastatin group there were 50% less patients with new angiographic lesions if cotreated with CCBs as compared with no CCB cotreatment, whereas in the placebo (no pravastatin) group, again, no significant effect of CCB treatment was observed. No beneficial effects of CCB treatment on clinical events were observed during the 2-year study follow-up. In view of the correlation between angiographic progression and subsequent clinical events as demonstrated in several large trials, it is not unrealistic to also anticipate in this population, a beneficial effect on clinical events with longer follow-up. Although the REGRESS trial was not designed to evaluate combination therapy, the results suggest that addition of CCBs to HMG-CoA reductase inhibitor therapy (pravastatin) acts synergistically in retarding the progression of established coronary atherosclerosis. These results appear to warrant prospective randomized trials to determine in a more definitive manner the merits of this combination in the prevention of progression of coronary atherosclerosis. Currently a number of studies in these fields are being designed or are already underway.
Cardiovascular Drugs and Therapy 03/1998; 12:111-118. · 3.13 Impact Factor
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ABSTRACT: Background. The cardiovascular applications of magnetic resonance (MR) techniques in coronary artery disease have increased considerably in recent years. Technical advantages of MR imaging are the excellent spatial resolution, the characterization of myocardial tissue, and the potential for three-dimensional imaging. These characteristics allow the accurate assessment of left ventricular mass and volume, the differentiation of infarcted from normal tissue, and the determination of systolic wall thickening and regional wall motion abnormalities. Methods. In addition to the conventionally used spin-echo and cine-echo techniques, newer techniques such as myocardial tagging, ultrafast MR imaging and MR coronary angiography have been developed. These newer techniques allow a more accurate assessment of ventricular function (tagging), myocardial perfusion (ultrafast imaging), and evaluation of stenosis severity (MR coronary angiography). Particularly early detection and flow assessment of stenosed coronary arteries and bypasses by MR angiography would constitute a major breakthrough in cardiovascular MR imaging. Apart from the MR imaging techniques, cardiac metabolism may be well assessed using MR spectroscopy. This provides unique information on the metabolic behaviour of the myocardium under conditions stress-induced ischemia. However, the definite niche of cardiac MR spectroscopy has still to be settled. Conclusion. Currently, MR techniques allow the evaluation of anatomy and function (accepted use), perfusion and viability (development phase), and coronary angiography (experimental phase). A particular strength of MR imaging is that one single MR test may encompass cardiac anatomy, perfusion, function, metabolism and coronary angiography. The replacement of multiple diagnostic tests with one MR test may have major effects on cardiovascular healthcare economics and would outweigh the cost inherent to the MR angiography procedure.
International Journal of Cardiac Imaging 05/1997; 13(3):179-189.
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ABSTRACT: Intravascular instrumentation may induce syncope or presyncope. It is not known whether asymptomatic subjects also have autonomic reactions, albeit concealed. We addressed this issue by studying 44 healthy young male subjects of various levels of fitness, ranging from inactivity to athletic [mean maximal oxygen uptake was 49.1 (SD 10.7) mlkg–1min–1, range 28.7–71.9 mlkg–1min–1]. The autonomic response to venous cannulation was quantified by measuring heart rate before cannulation (HR1), after cannulation (HR2), and after complete pharmacological autonomic blockade (HR0 = the intrinsic heart rate). The sympathovagal balance before and after cannulation was computed as HR1/HR0 and HR2/HR0, respectively. The group means of heart rate and sympathovagal balance decreased significantly (paired Student's t-test P <0.01) from 62.5 to 59.9 beatsmin–, and from 0.71 to 0.68, respectively. The maximal decrease in heart rate was 8.8 beatsmin–1, and in the sympathovagal balance was 0.11. Our study demonstrated that the asymptomatic subjects responded to intravenous instrumentation with a concealed autonomic reaction. Thus, from our findings it would seem that intravenous instrumentation interferes with measurements relating to autonomic nervous system activity.
European Journal of Applied Physiology and Occupational Physiology 04/1996; 73(1):113-116.
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ABSTRACT: Nisoldipine is a calcium antagonist with potent coronary vasodilating effects in patients with chronic stable angina pectoris. In an initial study we showed that intravenous nisoldipine, given 24–72 hours after uncomplicated myocardial infarction, was a safe and feasible intervention that had beneficial effects on global and regional myocardial function. We subsequently studied the acute effects of nisoldipine in six patients within 24 hours (mean 144 hours) after the onset of myocardial infarction. Nisoldipine was administered as a 4.5 g/kg intravenous bolus over 3 minutes, followed by intravenous infusion of 0.2 g/kg over 60 minutes. Radionuclide angiography, cardiac output, and intraarterial blood pressure measurements were performed before and during nisoldipine. Left ventricular ejection fraction increased from 48.310.3% to 55.311.8% (p=0.034) during nisoldipine infusion. Regional wall motion score changed during nisoldipine infusion from 3.32.5 to 1.82.6 (p=0.027). Cardiac output increased from 5.51.0 to 7.31.3 1/min (p=0.0001). I eart rate increased from 7812 to 8811 min–1 (p=0.004). Mean arterial blood pressure decreased from 9220 to 7913 mmI g (p=0.038). The rate-pressure product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine improves global and regional left ventricular function in patients with acute myocardial infarction within the first 24 hours.
Cardiovascular Drugs and Therapy 04/1994; 8:345-351. · 3.13 Impact Factor
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Coronary Artery Disease 05/1993; 4(6):505-511. · 1.24 Impact Factor
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ABSTRACT: Scintigraphic techniques can be used first, to guide appropriate referral for interventional procedures, and second to predict the effect of revascularization on regional perfusion and functionprior to the intervention, thereby being able to assess efficacy of revascularization and to assess whether ischemia is the origin of recurrence of symptoms. Of increasing importance is the ability of nuclear techniques to identify those myocardial regions with abnormal function which might benefit from revascularization by showing improvement in regional wall motion. Positron emission tomography is considered to be the gold standard to assess regional myocardial perfusion and metabolism. The introduction of the reinjection technique makes201Tl-scintigraphy the method of choice to detect jeopardized myocardium and to guide appropriate referral for revascularization procedures in those institutes where PET is not available. Even when the costly PET-instrumentation is available, cost-benefit analysis is indicated to assess the additional value of PET compared with201Tl reinjection imaging.
International Journal of Cardiac Imaging 02/1993; 9:49-58.
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ABSTRACT: To evaluate first pass in the right ventricular (RV) and left ventricular (LV) cavities and myocardial perfusion, subsecond MR imaging was performed in seven normal subjects following intravenous bolus injection of Gd-DTPA. After the baseline scans, sequential ECG-triggered images were obtained every three to four RR intervals. The procedure consisted of an initial presaturation puise (150[degrees]), and the acquistion time for one image was [almost equal to] 500 ms with 64 pahse-encoding steps. After bolus administration of Gd-DTPA (6.05 mmol/kg body wt), progressively increasing signal intensities were observed in the RV cavity, the LV cavity, and the myocardial wall. Gadolinium DTPA enhanced subsecond MR offers temporal information of the first transit in the cardiac chambers and may provide useful clinical reference data for assessment of myocardial perfusion in patients with coronary artery disease.
(C) Lippincott-Raven Publishers.
Journal of Computer Assisted Tomography 10/1991; 15(6). · 1.22 Impact Factor
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ABSTRACT: To evaluate interventricular septal motion and left ventricular function after aortic valve replacement for chronic aortic regurgitation, we studied 12 patients at rest and during exercise by radionuclide angiography after a mean of 19 (range 12–36) months after operation (group I). Twenty patients with chronic aortic regurgitation without aortic valve replacement served as controls (group II). None of the patients had coronary artery disease as documented by arteriography. Abnormal interventricular septal motion at rest was seen in 11 patients of group I, of whom 8 showed hypokinesis and 3 akinesis. During exercise, the interventricular septal wall motion improved in 4 patients, worsened in 3 patients and did not change in 5 patients. All patients of group II had normal interventricular septal motion at rest. During exercise, 5 patients showed septal wall hypokinesia together with apical and posterolateral wall motion abnormalities. The left ventricular ejection fraction at rest was 62% 20% in group I and 66% 8% in group II (not significant). During exercise, the left ventricular ejection fraction was 59% 24% in group I and 68% 13% in group II (not significant). We conclude that abnormal interventricular septal motion at rest is commonly found in patients with aortic valve replacement for chronic aortic regurgitation. During exercise, septal wall motion in the patients with aortic valve replacement shows a variable response from complete normalization to akinesia. These findings are mostly associated with a normal global left ventricular function both at rest and during exercise, which precludes myocardial ischaemia as a primary cause for abnormal septal wall motion after aortic valve replacement.
European journal of nuclear medicine and molecular imaging 04/1990; 17(5):252-256. · 4.99 Impact Factor
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ABSTRACT: To establish test specific normal limits for quantitative analysis of uptake and washout of 201Tl after dipyridamole infusion combined with low level exercise, 20 healthy volunteers were studied with low likelihood of coronary artery disease (CAD) assessed by a stepwise probability analysis based on age, sex, symptoms, resting electrocardiogram, and exercise electrocardiography. Likelihood of CAD in these volunteers was calculated as 1%. After dipyridamole infusion combined with low level exercise, one volunteer complained of headache; no other side effects were observed. There were no chest pain complaints. Maximal hemodynamic changes were achieved during the 6th and 7th min of the test. No ST segment depression was recorded. Visual analysis of the 201Tl scintigrams was normal in all volunteers. Mean regional washout at 4 h was 44.37%2.11%. The regional washout in the 70 LAO view (46.65%1.10%) was significantly higher than in the anterior and 30 LAO views (43.44%1.50% and 43.02%1.45%, respectively). Profiles of uptake and washout of 201Tl were different after dipyridamole infusion combined with low level exercise as compared to maximal exercise. Thus, in quantitative analysis of 201Tl scintigraphy after dipyridamole infusion in conjunction with low level exercise as applied in the present study, it is mandatory to use normal limits of uptake and washout of 201Tl derived from healthy volunteers who underwent the same combined protocol.
European journal of nuclear medicine and molecular imaging 04/1989; 15(5):239-243. · 4.99 Impact Factor
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ABSTRACT: The diagnostic accuracy of spin-echo Magnetic Resonance (MR) imaging in the detection and localization of a recent myocardial
infarction (mean 4 days old) was compared to planar thallium-201 scintigraphy in 20 patients with a documented myocardial
infarction. A control group of 10 subjects underwent a similar MR imaging procedure without thallium-201 scintigraphy. T1-weighted
MR images (TE 30 msec) showed abnormal thinning of the infarcted left ventricular wall during systole (<50% of the opposite
wall) in 11 patients (55%). On T2-weighted multi-echo MR images, (TE 30–60–90–120 msec) abnormally increased signal intensity
was found in 17 patients and coincided with the location of the infarction. Thallium-201 scintigraphy detected the infarction
in 18 patients. Comparison of T2-MR imaging and thallium-201 scintigraphy showed concordant findings in 82% of the left ventricular
segments. In 9% of segements, thallium uptake was reduced with normal T2-MR and in 9% we found a normal thallium uptake with
abnormal T2-MR findings. In all subjects of the control group, T1-MR images were normal, and only one subject showed increased
signal intensity on T2-MR images. We conclude that the diagnostic accuracy of MR imaging in detecting a myocardial infarction
is similar to that of T1-201 scintigraphy.
CardioVascular and Interventional Radiology 04/1989; 12(3):119-124. · 2.09 Impact Factor
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ABSTRACT: To assess the value of the paramagnetic contrast agent Gadolinium (Gd)-DTPA in Magnetic Resonance Imaging (MRI) of acute myocardial infarction (AMI), we studied 20 patients with a first AMI by ECG-gated MRI before and after intravenous administration of 0.15mmol/kg Gd-DTPA. The MRI studies were performed after a mean of 98 hours (range 15–241) after the acute onset of AMI. Spin-echo measurements (TE 30 msec) were made using a Philips Gyroscan (0.5 Tesla). After performing the baseline MRI scans, the MRI procedure was repeated every 10 minutes for up to 40 minutes following injection of Gd-DTPA. In 18 (90%) patients contrast enhancement in the infarcted myocardial areas was observed after Gd-DTPA. In these patients intensity versus region curves, derived from 9 to 11 adjacent myocardial regions of interest, showed increased signal intensities in the infarcted areas after administration of Gd-DTPA. The precontrast signal intensity ratio between infarcted and normal myocardium was 1.140.15 (meanSD); the postcontrast ratios at 10 minutes were 1.410.21 (P < 0.05),="" and="" at="" 40="" minutes="" 1.330.20="" (p="NS)." it="" is="" concluded="" that="" mri="" using="" the="" contrast="" agent="" gd-dtpa="" significantly="" improves="" the="" visualization="" and="" detection="" of="" infarcted="" myocardial="" areas="" in="" patients="" with="" ami="" and="" that="" optimal="" contrast="" enhancement="" is="" obtained="" 20="" minutes="" after="" administration="" of="">
International Journal of Cardiac Imaging 01/1989; 5(1):1-8.
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ABSTRACT: The acute effects on left ventricular function of nisoldipine were studied in six patients 5612 hours (range 44 to 72 hours) after the onset of uncomplicated acute myocardial infarction. Nisoldipine was administered as a 4.5 g/kg intravenous bolus over 3 minutes followed by an infusion of 0.2 g/kg during 60 minutes. Radionuclide angiography and two-dimensional echocardiography were performed before and during infusien with nisoldipine. The left ventricular ejection fraction increased significantly from 38%10% to 49%10% (P=0.028) during nisoldipine infusion. Regional wall motion index was determined both by radionuclide and by two-dimensional echocardiography and showed a significant change during nisoldipine infusion from 1.90.3 to 1.50.3 (p=0.028, radionuclide angiography) and from 0.70.2 to 0.30.2 (p=0.043, two dimensional echocardiography). Heart rate increased significantly from 7812 min-1 to 9213 min-1 (p=0.028), but mean double product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine significantly improves global and regional left ventricular function in patients shortly after acute myocardial infarction. This beneficial effect may, however, be partially offset by an increase in heart rate. Since mean double product did not change, it is suggested that nisoldipine may improve coronary blood flow in patients with acute myocardial infarction.
Cardiovascular Drugs and Therapy 01/1988; 2(5):673-678. · 3.13 Impact Factor
