[Effects of verapamil on the left ventricular diastolic function and diastolic asynchrony in patients with hypertrophic cardiomyopathy].
The effects of verapamil on the diastolic function and regional asynchrony of the left ventricle were echocardiographically investigated in 37 patients with hypertrophic non-obstructive cardiomyopathy (HCM). Before and 20 min after the intravenous administration of verapamil (0.1 mg/kg), blood pressure (BP), heart rate (HR), transmitral pulsed Doppler indices (R, A, A/R), M-mode echo indices (Dd, Ds, %FS) and the echo-phonocardiographic index (isovolumic relaxation time; IRT) were measured. We also measured the rapid extension times of the posterior walls at the chordae and papillary muscle level [Tc(pw), Tp(pw)] as the indices of regional diastolic function, and their difference [Tp-c(pw)] was used as the index of diastolic asynchrony. Before verapamil administration, the HCM patients had significantly larger A, A/R, IRT and Tp-c(pw) and smaller R than did 20 healthy controls, but showed no significant differences in HR, BP, Dd, Ds and %FS. After verapamil injection, R increased and A, A/R, IRT, Tp-c(pw) decreased significantly without any changes in BP and HR. The increment of R (delta R) correlated significantly with the decrement of Tp-c(pw) (r = -0.66, p less than 0.001). According to the value of delta R/R, 37 patients with HCM were categorized in 2 groups (19 responders with delta R/R greater than or equal to 10% and 18 non-responders with delta R/R less than 10%). The responders had smaller R and larger A/R, IRT and Tp-c(pw) before verapamil administration than did the non-responders. Verapamil increased R, Dd, Ds and decreased A, A/R and Tp-c(pw) in the responders, but not in the non-responders. These results suggested that verapamil might improve left ventricular diastolic function in HCM patients through the improvement of left ventricular diastolic asynchrony.
Emoto
R
R
First Department of Internal Medicine, Kobe University School of Medicine.
Yokota
Y
Y
Miki
T
T
Usuki
S
S
Miki
T
T
Nomura
H
H
Takeuchi
Y
Y
Nakatani
M
M
Fukuzaki
H
H
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D003971:Diastole / Q000187:drug effects*; D004452:Echocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D016277:Ventricular Function, Left / Q000187:drug effects*; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
D014700:Verapamil