Doppler flow and echocardiography in functional cardiac insufficiency: Assessment of nisoldipine therapy. Results of the DEFIANT-II study

P. A. Poole-Wilson, P. Hanrath, N. Gerich, U. Flachskampf, B. De Bruyne, J. Bartunek, P. Goemaere, A. Carreras, A. Bayes de Luna, M. Schartl, W. Bocksch, D. Barkow, S. Beckmann, S. Dreysse, R. J C Hall, S. Ikram, A. Yapanis, H. Saunders, R. Seabra-Gomes, M. MendesL. Brizida, M. Canada, M. J. Andrade, A. Lauten, G. Oltmans, A. Lang, H. Schwela, J. Machecourt, B. Bertrand, B. S. Lewis, A. Merdler, D. A. Halon, T. Dagan, F. Dienstl, H. Hoertnagl, P. Lechleitner, R. Eiter, A. Keren, Z. Khoury, V. Gabay, A. Friart, Y. Devaleriola, C. Philippart, J. McLenachan, J. Smyllie, L. Engelmann, H. J. Duck, B. Krosse, H. Pankau, C. Ribeiro, R. Ferreira, M. J. Correira, F. Pais, A. Araujo, A. P. Monteiro, J. G. Azevedo, M. Melo, A. Bordalo, L. Botas, M. G. St John Sutton, G. Sutton, M. I M Noble, P. Stubbs, E. Ramhamadamay, X. Andre-Fouet, M. P. Mulin, R. Erbel, U. Nixdorff, J. E. Otterstad, G. Froeland, M. Previtali, A. Mussini, A Distante A, P. Fioretti, M. Motro, Z. Vered, M. S. Feinberg, J. Shemesh, P. Benjamin, N. Holwerda, P. Melman, M. Casaccia, W. Bottone, E. Bellone, A. De Bernadi, L. Hatle, K. Bjoernstad, S. Askhus, T. Hole, S. Samstad, J. Soma, P. Marino, P. Zardini, M. Anselmi, L. Rossi, L. Zanolla, G. P. Nidasio, B. Marchandise, E. Schroeder

Research output: Contribution to journalArticlepeer-review


Aims. A multicentre, double-blind, placebo-controlled trial was conducted in 542 patients, randomized 7-10 days after myocardial infarction, to study the effect of nisoldipine coat-core (nisoldipine-CC) on exercise after 6 months. Secondary endpoints included exercise-induced ischaemia, left ventricular function measured by Doppler echocardiography, adverse cardiac events and clinical outcome. Methods and results. Patients had reduced left ventricular ejection fraction between 25 and 50%, but no heart failure. Exercise time was not different in the two groups. Nisoldipine-CC prolonged time to 1 mm ST deviation (P = 003). There was an effect of nisoldipine-CC of +3.6 cm.s-1 early peak velocity (P = 0.01) and of - 6.2 ms on isovolumic relaxation time (P = 0.005), but no effects on left ventricular volumes or ejection fraction. There was a trend towards reduced mortality (one death in the nisoldipine-CC group vs seven in the placebo group, P <0.07) and the combined end-point of mortality and cardiac events (P = 0.09). Peripheral oedema occurred in 49 patients assigned to nisoldipine-CC and two assigned to placebo (P <0.001). There were no differences in non-cardiac events. Conclusions. Nisoldipine-CC did not improve exercise time but increased time to 1 mm ST deviation, and improved diastolic left ventricular function. It is safe and well tolerated in post-infarction patients with impaired left ventricular function.

Original languageEnglish
Pages (from-to)31-40
Number of pages10
JournalEuropean Heart Journal
Issue number1
Publication statusPublished - 1997


  • Bicycle ergometry
  • Calcium antagonist
  • Doppler echocardiography
  • Post-MI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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