Long-term clinical effect of calcium inhibitors in hypertrophic cardiomyopathy compared to the effect of beta-blocking agents. A preliminary report with special reference to the beneficial effect of nifedipine on angina pectoris.
Long-term clinical effects of beta-blockers (propranolol in most cases) and calcium inhibitors (nifedipine in most cases) were studied in 16 patients with hypertrophic cardiomyopathy. On overall subjective symptoms, beta-blockers were effective in 50% of symptomatic patients, while calcium inhibitors were effective in only 33%. On angina pectoris, however, calcium inhibitors were superior to beta-blockers in our patients. Blood pressure decreased with each drug, and the decrease was significant with nifedipine. Otherwise there was no change in physical findings with either drug. Long-term (more than 6 months) use of beta-blockers resulted in an increase in cardiothoracic ratio on chest X-ray, a decrease in left ventricular ejection fraction on echocardiogram and more pronounced ST-T change on electrocardiogram. Prolonged use of nifedipine resulted in a slight decrease in cardiothoracic ratio, but no systematic change on echocardiogram and on electrocardiogram.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000787:Angina Pectoris / Q000188:drug therapy* / Q000209:etiology; D001794:Blood Pressure / Q000187:drug effects; D002118:Calcium / Q000037:antagonists & inhibitors*; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use*; D014700:Verapamil / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D011725:Pyridines; D011433:Propranolol; D014700:Verapamil; D009543:Nifedipine; D002118:Calcium