What question did this study set out to answer?

To assess the acute hemodynamic and antianginal effects of sublingually administered nifedipine in patients with coronary artery disease during stress and at rest.

June 1, 1982CirculationOpen Access

Acute hemodynamic effects of nifedipine in patients with ischemic heart disease.

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Why the study?

Does sublingual nifedipine acutely improve hemodynamics and ischemia in patients with coronary artery disease?

Population

20 patients with angiographically proved coronary artery disease, including subgroups evaluated during…

Comparison

Nifedipine 20 mg administered sublingually. vs Baseline (pre-intervention control values).

Design

Cohort

Follow-up

acute

Authors

PMP A MajidBaylor College of Medicine JJJonas de JongOLVG

Discussion

Member takes

Implication

Sublingual nifedipine may relieve acute ischemia in CAD; hypothesis-generating and should not yet change practice without randomized confirmation.

Key Points

To assess the acute hemodynamic and antianginal effects of sublingually administered nifedipine in patients with coronary artery disease during stress and at rest.
Evaluated 20 patients with angiographically confirmed coronary artery disease across three testing protocols.
Studied 8 patients during exercise-induced angina, 6 patients during rapid cardiac pacing stress, and 6 resting patients with recent (<4 months) myocardial infarction and left ventricular dysfunction.
Administered 20 mg of sublingual nifedipine following baseline stress or rest evaluations, recording electrocardiographic changes, pulmonary wedge pressures, left ventricular volumes, and ejection fraction.
In both exercise and pacing groups, 20 mg sublingual nifedipine significantly shortened pain duration, reversed all stress-induced hemodynamic abnormalities, and reduced ST-segment depression (p < 0.001).
During pacing stress, left ventricular end-diastolic pressure had climbed from 16 ± 6 to 26 ± 6 mm Hg and ejection fraction had fallen from 0.60 ± 0.15 to 0.44 ± 0.11, both of which were completely reversed by nifedipine.
In resting patients with recent infarction and impaired left ventricular function, nifedipine lowered left ventricular end-diastolic pressure from 21 ± 6 to 12 ± 5 mm Hg and improved ejection fraction from 0.43 ± 0.08 to 0.58 ± 0.11.

Structured PICO

Does sublingual nifedipine acutely improve hemodynamics and ischemia in patients with coronary artery disease?

Population

20 patients with angiographically proved coronary artery disease, including subgroups evaluated during exercise-induced pain (n=8), pacing stress (n=6), and with recent (<4 months) acute myocardial infarction and moderately severe LV dysfunction at rest (n=6).

Intervention

Nifedipine 20 mg administered sublingually.

Comparator

Baseline (pre-intervention control values).

Outcome

Acute hemodynamic effects (pulmonary wedge pressure, left ventricular end-diastolic pressure, end-diastolic and end-systolic volumes, ejection fraction), duration of chest pain, and ST-segment depression.surrogate

Sublingual nifedipine acutely improves hemodynamics, reduces ischemia, and enhances systolic emptying without adverse effects in patients with coronary artery disease, including those with depressed LV function.

Cite This Study

Majid et al. (1982) studied this question.

synapsesocial.com/papers/6a711b9c84cc45bb7bdfe185 https://doi.org/10.1161/01.cir.65.6.1114

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Implication

Sublingual nifedipine may relieve acute ischemia in CAD; hypothesis-generating and should not yet change practice without randomized confirmation.

Acute hemodynamic effects of nifedipine in patients with ischemic heart disease.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Acute hemodynamic effects of nifedipine in patients with ischemic heart disease.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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