Effects of nisoldipine on left ventricular function during exercise or cold pressor stress

The effects of a single oral dose of nisoldipine, 10 mg, were investigated in two groups of patients. Firstly, the effects of nisoldipine on exercise left ventricular function were assessed in 20 patients with chronic stable angina and coronary disease. Secondly, the effects of nisoldipine on the left ventricular response to cold pressor stimulation were examined in 12 patients with normal coronary arteries, who presented with typical ischaemic chest pain and abnormal exercise tests. All studies were performed using first pass radionuclide angiography and the new short half-life radiopharmaceutical, gold-195m. In patients with coronary disease, mean exercise time improved after nisoldipine (P less than 0.01). Both at the identical workload to that before treatment, and at a new peak workload, mean exercise left ventricular ejection fraction (LVEF) improved significantly after nisoldipine (P less than 0.01 and P less than 0.05 vs pretreatment levels, respectively). At the identical workload to that before treatment, 10 of 16 patients, who had initially developed angina, did not develop angina after nisoldipine, and 23 of 46 exercise-induced regional left ventricular abnormalities had normalized. In the patients with normal coronary arteries undergoing cold pressor stimulation, imaging was carried out at rest, and after 1 and 2.5 minutes of cold stimulation, before and one hour after oral nisoldipine. LVEF fell significantly during cold stimulation before nisoldipine administration, with 10 of the 12 patients showing an abnormal response. Nisoldipine did not lead to any attenuation of the heart rate and blood pressure response to cold, but mean LVEF did not fall at any cold pressor stage and only three patients showed an abnormal response.(ABSTRACT TRUNCATED AT 250 WORDS)