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Acute hemodynamic effects of nicardipine in patients with chronic heart failure



Acute hemodynamic effects of nicardipine in patients with chronic heart failure



Cardiologia 34(12): 1013-1020



We evaluated haemodynamic parameters in 13 patients suffering from chronic heart failure (CHF) in III and IV NYHA class. They were 10 males and 3 females, average age 57 .+-. 11 years. Haemodynamic monitoring was made at basal condition and for 40 min afte the administration of nicardipine (10 mg iv). We observed that mean arterial pressure and systemic vascular resistances (SVR) showed an important decrease (respectively, -10.8%, p < 0.001 and -22%, p < 0.001); total pulmonary resistances (TPR) also decreased (-16.6%, p < 0.001), while mean pulmonary pressure did not show significant reduction. Cardiac index increased with the highest value at the fifteenth minute (-11.7%, p < 0.01). Pulmonary wedge pressure (PWP) did not show variations, and heart rate too. Cardiac index (CI) did not rise in 3 patients with clinical worsening during the monitoring (patients non responders) (CI increase was less than 15%); while in 10 patients CI increased more than 15% (patients responders). Patients non responders, did not show any decrease of TPR and only a transitory reduction of SVR; patients responders showed an important decrease of TPR, SVR, PWP. We observed that at baseline, the difference between the 2 groups was based on the value of TPR and PWP. We conclude that nicardipine is an efficient drug in patients affected by CHF without severe hemodynamic failure.

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