Document Detail


Clinical effects and utility of intracoronary diltiazem.
MedLine Citation:
PMID:  7497500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary artery spasm is a known complication of coronary interventions, for which intracoronary nitroglycerin (ICN) is the treatment of choice. Some forms of intense spasm are resistant to ICN. Calcium channel antagonists are also known to be effective for coronary artery spasm, including nitroglycerin-resistant spasm. Here we describe a protocol for the clinical use of intracoronary diltiazem (ICD). By this protocol, ICD can be safely given without disturbing the clinical status of patients. ICD (2.5 mg) given slowly over 1 minute produced no vasodilitation of normal vessel segments but did produce significant dilatation of stenotic segments above and beyond the effects of nitrates. Mean minimum lumen diameter increased 18%, from 0.89 +/- 0.06 mm to 1.06 +/- 0.07 mm (mean +/- SEM, P < 0.001). ICD produced clinically insignificant changes in systolic blood pressure, diastolic blood pressure, heart rate, and PR, QRS, and QT intervals. This protocol has been employed to safely use ICD to relieve both nitroglycerin-resistant epicardial artery spasm and nitroglycerin-resistant distal microvascular spasm (the no-reflow phenomenon).
Authors:
M E McIvor; C Undemir; J Lawson; J Reddinger
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  35     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1996-01-18     Completed Date:  1996-01-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  287-91, discussion 92-3     Citation Subset:  IM    
Affiliation:
All Children's Hospital, St. Petersburg, Florida, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Clinical Protocols
Coronary Angiography
Coronary Vasospasm / drug therapy*,  physiopathology,  radiography
Diltiazem / administration & dosage*
Electrocardiography
Hemodynamics / drug effects
Humans
Infusions, Intra-Arterial
Nitroglycerin / administration & dosage
Pilot Projects
Vasodilator Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 42399-41-7/Diltiazem; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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