Hemodynamic evaluation of nifedipine in primary pulmonary hypertension:Short and long term effects Seiji Yamaguchi 1 , Kai Tsuiki 1 , Makio Hayasaka 1 , Masaki Oguma 1 , Ikuro Ohta 1 , Tetsuji Kaminishi 1 , Hiroyasu Sukekawa 1 , Tohru Kanaya 1 , Shoji Yasui 1 1The First Department of Internal Medicine, Yamagata University School of Medicine pp.171-176
Published Date 1986/2/15
DOI https://doi.org/10.11477/mf.1404204821
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The reported efficacy of vasodilators in primary pulmonary hypertension (PPH) has been contro-versial. We assessed the acute hemodynamic effects of nifedipine (nif) in 4 female patients with PPH (age: 40 years in average). The effects were compared with those of isosorbide dinitrate (ISDN). In addi-tion, chronic (2 months) hemodynamic effects of nif were evaluated.

Cardiac catheterization was performed and car-diac index (CI), heart rate (HR), mean systemic and pulmonary arterial pressures (Aom and PAPm), total systemic and pulmonary resistances (TSR and TPR), PaO2, PaCO2 and A-aDO2 were determined before the administration of drugs and at the peak effects of sublingual nif (10mg) or ISDN (5mg).

After nif sublingually, CI increased from 2.4 to 3.0l/min/m2 (ΔCI=25%), PAPm decreased from 57 to 53 mmHg (ΔPAPm= -7%) and TPR decreased from 1502 to 1205 dyne・sec・cm-5 (ΔTPR = -23%). These favorable effects were marked in 2 patients with short symptomatic history. A-aDO2 was enhanced in 3 patients (mean; 36.6 to 40.6 mmHg), probably due to the deterioration of ven-tilation/perfusion relationship. ISDN decreased PAP slightly, but aggravated low CO and high TPR in contrast with nif.

The long-term (2 months) effects of internal use of nif (40~60mg, daily) were evaluated in 2 pa-tients who had good response in short-term hemo-dynamic effects of nif. They had improved clinical symptom, although the hemodynamic reexamination showed favorable effect in one patient after 2 hours and no change in the other after 12 hours from the last administration of nif (10mg). It was sug-gested that the hemodynamic effects of nif in PPH can be dependent upon the time course after the administration, and therefore nif should be given at least more than three times a day. Thus, nif may be a useful drug in selected patients with PPH.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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