Acute effects of gallopamil on left ventricular systolic and diastolic function in patients with ischaemic heart disease.
In 13 patients with chronic stable angina, left ventricular pressures were measured by catheter-tip micromanometer, and left cineventriculography was performed at matched atrial paced rates before and 20 min after administration of intravenous gallopamil (3 mg). Mean plasma concentration of gallopamil at the second haemodynamic and angiographic assessment was 18.6 +/- 5.7 ng.ml-1. Left ventricular peak systolic pressure decreased from 134 +/- 12 to 125 +/- 13 mmHg (P less than 0.005) and mean aortic pressure from 94 +/- 11 to 91 +/- 9 mmHg (ns). Peak positive first derivative of left ventricular pressure (+dP/dt) and maximal velocity of the contractile element (Vcemax) significantly decreased (from 1828 +/- 334 to 1702 +/- 304 mmHg.s-1, P less than 0.002, and from 51 +/- 11 to 43 +/- 5 s-1, P less than 0.001, respectively). Left ventricular protodiastolic pressure decreased from -0.6 +/- 2.9 to -2.8 +/- 2.9 mmHg (P less than 0.005) and left ventricular end-diastolic pressure from 9.5 +/- 3.4 to 8.9 +/- 4.6 mmHg (ns). No changes occurred in peak negative dP/dt, while a significant reduction was observed in the exponential time constant of the first 40 ms of isovolumetric relaxation (t-constant decreased from 38 +/- 8 to 34 +/- 7 ms, P less than 0.01). No changes were observed in end-diastolic and end-systolic left ventricular volume indices and ejection fraction. Thus, intravenous gallopamil induced a moderate afterload reduction and a slight negative inotropic effect resulting in a net effect of unchanged left ventricular pump function. The observed improvement of early relaxation seems to be a potentially beneficial effect of gallopamil in patients with coronary artery disease.
Division of Cardiology, Ospedale Civile, Bassano del Grappa (VI), Vicenza, Italy.
C
C
Di Mario
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A
Iavernaro
F
F
Cucchini
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial; D003327:Coronary Disease / Q000188:drug therapy*; D003971:Diastole / Q000187:drug effects; D005260:Female; D005711:Gallopamil / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009040:Motion Pictures; D009200:Myocardial Contraction / Q000187:drug effects; D015635:Radionuclide Ventriculography; D013599:Systole / Q000187:drug effects; D016277:Ventricular Function, Left / Q000187:drug effects*
D005711:Gallopamil