Document Detail

Comparison of acute reduction in left ventricular outflow tract pressure gradient in obstructive hypertrophic cardiomyopathy by disopyramide versus pilsicainide versus cibenzoline.
MedLine Citation:
PMID:  21029829     Owner:  NLM     Status:  MEDLINE    
Negative inotropic agents are often administered to decrease the left ventricular (LV) pressure gradient in patients with obstructive hypertrophic cardiomyopathy (HC). Little information is available regarding comparisons of the effects on LV pressure gradient among negative inotropic agents. The present study compared the decrease in the LV pressure gradient at rest in patients with obstructive HC after treatment with pilsicainide versus treatment with disopyramide or cibenzoline. The LV pressure gradient and LV function were assessed before and after the intravenous administration of each drug. In 12 patients (group A, mean pressure gradient 90 ± 24 mm Hg), the effects of disopyramide, propranolol, and verapamil were compared. In another 12 patients (group B, mean pressure gradient 98 ± 34 mm Hg), a comparison was performed among disopyramide, cibenzoline, and pilsicainide. In group A, the percentage of reduction in the LV pressure gradient was 7.7 ± 9.9% with verapamil, 19.0 ± 20.2% with propranolol, and 58.6 ± 15.0% with disopyramide, suggesting that disopyramide was more effective than either verapamil or propranolol. In group B, the percentage of reduction in the LV pressure gradient was 55.3 ± 26.6% with disopyramide, 55.3 ± 20.6% with cibenzoline, and 54.7 ± 15.4% with pilsicainide, suggesting an equivalent effect on the LV pressure gradient for these 3 agents. In conclusion, these results indicate that the acute efficacy for the reduction of the LV pressure gradient at rest by pilsicainide (a pure sodium channel blocker) was equivalent to that of disopyramide or cibenzoline (combined sodium and calcium channel blockers). Accordingly, sodium channel blockade might be more important for reducing the LV pressure gradient at rest in patients with obstructive HC than calcium channel blockade or β blockade.
Katsuya Kajimoto; Taku Imai; Yuichiro Minami; Hiroshi Kasanuki
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1307-12     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Department of Cardiology, Tokyo Women’s Medical University, Japan.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use*
Cardiomyopathy, Hypertrophic / drug therapy*,  physiopathology,  ultrasonography
Disopyramide / therapeutic use*
Echocardiography, Doppler
Imidazoles / therapeutic use*
Lidocaine / analogs & derivatives*,  therapeutic use
Linear Models
Middle Aged
Propranolol / therapeutic use
Prospective Studies
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy*,  physiopathology,  ultrasonography
Ventricular Pressure / drug effects*
Verapamil / therapeutic use
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Imidazoles; 137-58-6/Lidocaine; 3737-09-5/Disopyramide; 52-53-9/Verapamil; 525-66-6/Propranolol; 53267-01-9/cifenline; 88069-49-2/pilsicainide

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

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