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Chest, Vol 86, 14-19, Copyright © 1984 by American College of Chest Physicians

ARTICLES

Hemodynamic effects of nifedipine at rest and during exercise in primary pulmonary hypertension

MT Olivari, TB Levine, EK Weir and JN Cohn

The potential short-term pulmonary vasodilator effect of a calcium- channel blocker, nifedipine, was tested in seven patients with primary pulmonary hypertension. Nifedipine (20 mg) produced a significant (p less than 0.01) and persistent decrease in mean pulmonary arterial pressure (58.1 +/- 14.3 to 48.6 +/- 16.3 mm Hg) and pulmonary vascular resistance (1,070 +/- 260 to 695 +/- 266 dynes X sec X cm-5). Cardiac index increased from 2.5 +/- 0.6 to 3.3 +/- 0.8 L/min/m2 (p less than 0.01), and heart rate was unchanged despite a fall in systemic pressure. In three patients tested during exercise on a bicycle, nifedipine resulted in an increase in the duration of exercise in two and a blunting of the exercise-induced increase in pulmonary pressure in all three. Long-term treatment was initiated in five of the seven patients and in two additional patients who did not receive nifedipine in the short-term study; all but one experienced symptomatic improvement. A persistent hemodynamic improvement was observed in three of the four patients restudied after long-term therapy. In conclusion, this study demonstrated the short-term beneficial hemodynamic effects of nifedipine, both at rest and during exercise. A more extensive long- term follow-up is necessary to establish the usefulness of this drug in the treatment of primary pulmonary hypertension.


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