Effects of nisoldipine on exercise-induced hemodynamic changes in stable angina pectoris.

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To examine antianginal effects of nisoldipine, a new calcium channel blocker, 10 patientswith effort angina pectoris were studied. Hemodynamic data were obtained by anginalimited supine multistage bicycle ergometer exercise testing before and after single oraladministration of 10mg of nisoldipine.<BR>After nisoldipine, chest pain at peak exercise disappeared or abated, and ST segmentat peak exercise also showed less significant depression. At rest and peak exercise, meanblood pressure, pulmonary artery wedge pressure and systemic vascular resistance decreasedsignificantly, whereas, heart rate increased significantly after nisoldipine. At rest, cardiacindex increased significantly after nisoldipine. At peak exercise, coronary sinus flowtended to increase after nisoldipine. Stroke volume index and myocardial oxygen consumption did not change significantly. Average time to peak plasma nisoldipine concentration was 1.6 hours and average peak plasma concentration was 13.8ng/ml with anelimination half-life of 1.6 hours.<BR>Thus, nisoldipine is an active antianginal drug; its major mechanism of action is to lowersystemic vascular resistance and to improve coronary blood flow during exercise.