| Effects of verapamil on left ventricular systolic function and diastolic filling in patients with hypertrophic cardiomyopathy. | |
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MedLine Citation:
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PMID: 7196813 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Verapamil improves exercise capacity in patients with hypertrophic cardiomyopathy (HCM), but its mechanism of action are unknown. We examined the effects of oral verapamil (320-480 mg/day) on resting left ventricular (LV) systolic and diastolic function in patients with HCM. High-temporal-resolution time-activity curves from gated technetium-99m radionuclide angiograms were analyzed before and after verapamil therapy in 40 patients, of whom 16 were also studied during propranolol therapy (80-960 mg/day). All but one patient had normal or supranormal systolic function, but 70% had evidence of diastolic dysfunction, defined as peak LV filling rate (PFR) less than 2.5 end-diastolic volumes (EDV)/sec or time to PFR greater than 80 msec. Verapamil did not change LV ejection fraction, peak ejection rate or ejection time, but did increase PFR (control 3.3 +/- 1.0 EDV/sec, verapamil 4.1 +/- 1.1 EDV/sec; p less than 0.001) and reduce time to PFR (control 187 +/- 56 msec, verapamil, 159 +/- 34 msec; p less than 0.001). Only 30% of patients had evidence of diastolic dysfunction during verapamil. In contrast, propranolol did not change LV ejection fraction, PFR or time to PFR, but did prolong ejection time and reduce peak ejection rate. Thus, LV diastolic filling is abnormal in a high percentage of patients with HCM, and verapamil normalizes or improves these abnormalities without altering systolic function. This mechanism may contribute to the clinical improvement of many HCM patients during verapamil therapy. |
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Authors:
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R O Bonow; D R Rosing; S L Bacharach; M V Green; K M Kent; L C Lipson; B J Maron; M B Leon; S E Epstein |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 64 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1981 Oct |
Date Detail:
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Created Date: 1981-11-22 Completed Date: 1981-11-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 787-96 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Cardiomyopathy, Hypertrophic / drug therapy* Diastole / drug effects* Heart Rate / drug effects Heart Ventricles / drug effects, radionuclide imaging Humans Middle Aged Myocardial Contraction / drug effects* Propranolol / therapeutic use Stroke Volume / drug effects Systole / drug effects* Verapamil / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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52-53-9/Verapamil; 525-66-6/Propranolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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