Calcium channel blockade in dialysis patients with left ventricular hypertrophy and well-preserved systolic function.
Echocardiographic evidence of left ventricular hypertrophy with well-preserved systolic function was established in 4 chronic hemodialysis patients with a history of refractory pulmonary congestion. In each patient a trial of treatment with verapamil (40 mg t.i.d.) resulted in symptomatic improvement, an increase in nadir intradialysis blood pressure, and a marked reduction in intradialytic symptomatic hypertensive episodes and the need for intravenous saline administration. These data suggest that (a) a subset of chronic hemodialysis patients with refractory congestive heart failure and dialysis-related hypotension have hypertrophic cardiomyopathy with well-preserved systolic function, and (b) such patients may derive greater benefit from verapamil treatment than from the more conventional approach to drug therapy with digoxin and nitrates.
Whelton
P K
PK
Department of Epidemiology, Johns Hopkins University School of Hygiene, Baltimore, Maryland.
Watson
A J
AJ
Kone
B
B
Fortuin
N J
NJ
D000368:Aged; D001794:Blood Pressure; D001835:Body Weight; D006332:Cardiomegaly / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000033:anatomy & histology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D006435:Renal Dialysis; D013599:Systole; D014700:Verapamil / Q000627:therapeutic use*
D014700:Verapamil