Hemodynamic benefits of verapamil after aortic reconstruction.
Because of the high incidence of coronary artery disease (CAD) in patients undergoing aortic surgery, and because myocardial oxygen consumption is proportional to blood pressure x heart rate (HR) (pressure-rate product), it is important to prevent increases in these parameters postoperatively. The effect of verapamil, a calcium channel antagonist, on these parameters was evaluated in 30 patients undergoing abdominal aortic reconstruction. Postoperatively HR increased 27% in 19 patients without CAD and 47% in 11 patients with CAD. Pressure-rate product (blood pressure x HR) increased 17% and 31% in these two groups, respectively. Verapamil was able to reduce postoperative HR by 3% in patients without CAD and by 13% in patients with CAD. Verapamil reduced pressure-rate product 8% and 18%, respectively, in the two groups. These reductions were statistically significant in patients with CAD and occurred without reductions in cardiac output or left ventricular ejection fraction. Thus the postoperative increases in myocardial oxygen demand appeared to be primarily related to increased HR after aortic surgery, and these were reduced by verapamil without impairing blood flow or cardiac function.
Dahn
M S
MS
Department of Surgery, Veterans Administration Medical Center, Detroit, MI.
Wilson
R F
RF
Lange
M P
MP
Jacobs
L A
LA
Pozderac
R
R
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D001794:Blood Pressure / Q000187:drug effects; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects; D011184:Postoperative Period; D014700:Verapamil / Q000494:pharmacology / Q000627:therapeutic use*
D014700:Verapamil