Respiration
Original Paper
Nifedipine Attenuates Acute Hypoxic Pulmonary Vasoconstriction in Patients with Chronic Obstructive Pulmonary DiseaseBurghuber O.C.2nd Department of Internal Medicine, University of Vienna, Austria
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Article / Publication Details
Received: November 27, 1986
Accepted: March 18, 1987
Published online: January 16, 2009
Issue release date: 1987
Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0
ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)
For additional information: https://www.karger.com/RES
Abstract
The calcium channel blocker nifedipine was administered to patients with chronic obstructive pulmonary disease (COPD) to determine its efficiency as a pulmonary vasodilator. Since nifedipine has been shown to decrease elevated pulmonary artery pressures in patients with hypoxic pulmonary hypertension, we hypothesized that nifedipine would attenuate acute hypoxic pulmonary vasoconstriction in patients without pulmonary hypertension. We studied 11 clinically stable patients with mild to moderate COPD and normal pulmonary artery pressures using a randomized single-blind cross-over design. The patients were studied before and after nifedipine (20 mg) or placebo, given sublingually, at room air and subsequently during inhalation of a hypoxic gas mixture containing 13% O2, 5% CO2 and 72% N2. During normoxia, nifedipine significantly increased cardiac index from 4.2 ± 0.3 to 4.9 ± 0.5 liters/min/m2 (p < 0.05) and the coefficient of oxygen delivery from 4.15 ± 0.3 to 4.91 ± 0.5 (p < 0.05), whereas placebo treatment did not. During isocapnic hypoxia, a significant increase in mean pulmonary artery pressure (from 15.7 + 0.7 to 24.4+ 1.2 mm Hg; p < 0.005) and mean pulmonary vascular resistance index (from 2.6 ± 0.3 to 4.2 ± 0.5 mm Hg; p < 0.005) could be observed. Pretreatment with nifedipine significantly attenuated the hypoxia-induced increase in mean pulmonary artery pressure by 53 % and of the mean pulmonary vascular resistance index by 50%. This was accomplished without significant changes in systemic arterial pressure and in the systemic vascular resistance index. Thus, nifedipine acutely dilates the constricted vascular bed associated with hypoxia in these patients with COPD
© 1987 S. Karger AG, Basel
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Article / Publication Details
Received: November 27, 1986
Accepted: March 18, 1987
Published online: January 16, 2009
Issue release date: 1987
Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0
ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)
For additional information: https://www.karger.com/RES
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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