Vignaux O et al. (2005) Evaluation of the effect of nifedipine upon myocardial perfusion and contractility using cardiac magnetic resonance imaging and tissue Doppler echocardiography in systemic sclerosis. Ann Rheum Dis 64: 1268–1273

Cardiovascular analysis using highly sensitive and quantitative techniques shows that 14 days of treatment with nifedipine simultaneously improves myocardial perfusion and regional function in patients with systemic sclerosis (SSc).

Cardiovascular MRI and tissue Doppler echocardiography are recently developed techniques that have been shown to be more sensitive than conventional methods for the evaluation of myocardial perfusion and contractility, respectively. In this study they were used to evaluate myocardial perfusion and function in 18 patients with SSc without clinical heart failure and with normal pulmonary artery pressure. Patients were assessed at baseline, after a 72-hour wash-out period and after 14 days of treatment with oral nifedipine 60 mg/day. Results showed a significant increase in MRI perfusion index (mean 0.26 versus 0.19 at baseline, P = 0.0003) and in systolic and diastolic strain rate (2.3 s−1 versus 1.5 s−1 at baseline, P = 0.0002; and 4.2 versus. 3.0 at baseline, P = 0.0003) following 14 days of nifedipine.

The authors caution that these results should be considered as preliminary and that the long-term benefits of nifedipine in this setting are unknown; however, these findings confirm previous data and highlight the beneficial microvascular and cardiac effects of nifedipine, demonstrating that short-term (14 days) treatment has a marked beneficial effect on myocardial perfusion and function in patients with SSc.