A review of the haemodynamic effects of nicardipine in ischaemic heart disease

1 Nicardipine is a new peripherally selective slow calcium channel blocker. Like other dihydropyridine derivatives it appears to function as a systemic arteriolar vasodilator, and causes a significant reduction in left ventricular afterload. 2 Unlike the papaverine derivatives, and certain dihydropyridines, it does not demonstrate discernable cardiodepression in clinical situations. This appears due to selective vascular and myocardial sparing actions together with sympathetic activation and consequent counter-regulating corrective actions. 3 It has also been shown to improve coronary blood flow and to influence favourably myocardial metabolism. 4 Although there is currently limited information available, the combination of this drug with β-adrenoceptor blocking agents appears to optimise its haemodynamic profile. It may also be of benefit in the treatment of patients with left ventricular failure. 5 Further studies are required to confirm these findings and to establish the place of nicardipine in the therapeutic management of patients with coronary artery disease.