Improved diastolic function with the calcium antagonist nisoldipine (coat-core) in patients post myocardial...

Area of Science:

• Cardiology
• Pharmacology

Background:

• Left ventricular dysfunction is a common complication after myocardial infarction.
• Diastolic dysfunction can significantly impair cardiac function and exercise capacity.

Purpose of the Study:

• To evaluate the effect of long-acting nisoldipine on diastolic function in patients with recent myocardial infarction and mild left ventricular dysfunction.
• To assess changes in diastolic filling parameters and exercise capacity.

Main Methods:

• A multicentre, randomized, double-blind, placebo-controlled trial involving 135 patients.
• Patients received either 20 mg of nisoldipine or placebo once daily for 4 weeks.
• Diastolic function was assessed using Doppler and two-dimensional echocardiography.

Main Results:

• Nisoldipine significantly increased early diastolic peak velocity and the time velocity integral, indicating improved early diastolic flow across the mitral valve.
• A reduction in isovolumic relaxation time was observed, suggesting enhanced myocardial relaxation.
• Peak exercise workload increased by 12 watts in the nisoldipine group without significant changes in blood pressure or heart rate.

Conclusions:

• Long-acting nisoldipine improves indices of diastolic ventricular function in patients with recent myocardial infarction and mild left ventricular dysfunction.
• Nisoldipine also enhances exercise capacity in this patient population.
• The observed benefits may be attributed to an anti-ischemic effect or improved myocardial relaxation.