To research the effect of nifedipine forward aortic distensibility in patients with coronary artery disease.

To research the effect of nifedipine forward aortic distensibility in patients with coronary artery disease, ascending aorta distensibility was measured before and 10 min after 10 mg of nifedipine was given sublingually in 13 patients with coronary artery disease and 12 bridle subjects. Aortic distensibility was calculated as a function of changes in the aortic diameter and legumes pressure. Aortic diameters were measured by dint of echocardiography and aortic pressures were measured directly by the agency of catheterization of the ascending aorta. At baseline, aortic distensibility was lower in patients with coronary artery disease compared with mastery (0.922 [+ or -] 0367 v 2456 [+ or -] 0588 [10.sup.-6][multiplied by][cm.sup.2][multiplied by][dynsup-1] respectively, p[les than]0.001). After nifedipine administration, aortic distensibility increased significantly the two in normal subjects (by 0812 [+ or -] 0316 [10.sup.-6][multiplied by][cm.sup.2][multiplied by][dynsup-1] --365 [+ or -]19 percent; p[les than]0.001) and in patients with coronary artery disease (by 0296 [+ or -] 0203 [10.sup.-6][multiplied by][cm.sup.2][multiplied by][dynsup-1] --366 [+ or -] 282 percent; p [les than] 0001) These inferences indicate that nifedipine administration increases aortic distensibility in one as well as the other normal subjects and patients with coronary artery disease.

It is well appreciated today that functional properties of large arteries are important not solely for the normal function of the artery itself, on the contrary also for left ventricular function as well, since ventricular-vascular coupling mismatch may conclusion in reduction of ventricular performance.[1]

Previous studies from our laboratory[2-4] and other[5-7] laboratories have shown that distensibility of the ascending aorta is decreased in the demeanor of coronary artery disease. Other studies have also shown that calcium channel blocker have a direct action in succession the vascular system, decreasing sleek muscle tone not only in the peripheral arterial walls, moreover also in the aortic wall.[8] Indeed, nifedipine improves the distensibility of the descending aorta in experimental animals[9] and the distensibility of the ascending aorta in hypertensive patients.[10]

The purport of the calcium channel blocker forward the distensibility of the ascending aorta in patients with coronary artery disease has not been studied (to our knowledge). This investigation was undertaken to reflection the effect of nifedipine upon the distensibility of the ascending aorta in patients with coronary artery disease.

METHODS

cogitation Population

Eighty-two consecutive male patients, with an age range from 40 to 50 years, who had undergone diagnostic cardiac catheterization for evaluation of chest pain were preferableed as potential subjects for the thought Patients with arterial hypertension (systolic arterial compressing [greater than or equal to]140 mm Hg and/or diastolic arterial urgency [greater than or equal to]90 mm Hg) valvular heart disease, history of previous myocardial infarction, congenital heart disease, dilated cardiomyopathy, ejection fraction [les than]58 percent (value corresponding to the lower 95 percent confidence limits of the ejection fraction of the male bring under rules aged 40 to 50 years aged who undergon diagnostic catheterization in our institution for evaluation of chest pain and are fix to have normal coronary arteries), chronic obstructive pulmonary disease, history of cerebrovascular accident, and diabetes mellitus were exclud prior to ingress into the study. With these criteria, 28 of the initial 82 patients were selecteded In addition, three more patients with technically les than optimal echocardiograms were exclud from further analyses. The remaining 25 patients were divided into sum of two units groups according to the angiographic ensue Thirteen patients had coronary artery disease (luminal stenosis [greater than or equal to]50 percent in diameter) in at least common of the major coronary arteries. Twelve patients with entirely normal coronary arteries were used as normal ascendencys (patients with plaque disease, namely patients with coronary atherosclerotic lesions causing luminal stenosis [les than]50 percent in diameter, were also excluded) Treatment with all medications leaving out aspirin was discontinued at least five half-lives before the cogitation All subjects had normal serum electrolyte and normal issues of kidney and liver functional exhibitions The study protocol was approved at the institution committee on human research of our hospital and informed consensus was obtained from each enthrall after detailed description of the procedure

A 6-French fluid-filled pigtail catheter was introduced on a percutaneous technique via the right femoral artery and its tip was positioned subordinate to fluoroscopy in the ascending aorta. After 30 min pause in the supine position, echocardiograms and aortic constraining forces were recorded simultaneously before and 10 min after 10 mg of nifedipine given sublingually. Studies were performed at 9 AM in a less degree than a controlled room temperature of 20 [degrees] [+ or -] 05 [degrees] C

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