[Nifedipine in the treatment of hypertrophic non-obstructive cardiomyopathy].
The left ventricle of patients with hypertrophic cardiomyopathy is typically asymmetrically hypertrophied and noncompliant. The stiff, hypertrophied left ventricle plays a key role in the pathophysiology of hypertrophic cardiomyopathy with and without an outflow tract gradient. In 11 patients with hypertrophic cardiomyopathy without a resting outflow gradient, we assessed the effects of nifedipine (10 mg orally) on echocardiographic measurements of left ventricular (LV) relaxation and diastolic filling. Control and one hour post nifedipine M-mode and two-dimensional echocardiograms were performed and the following LV parameters were measured: end-diastolic dimension, systolic shortening, isovolumic relaxation time (IVRT, time from aortic component of the second heart sound to mitral valve opening; msec), maximal fiber lengthening velocity (-VCF; circ/sec), and the percent diameter increase during the rapid filling phase (%DRF; %). Cuff systolic blood pressure fell after nifedipine from 153 to 136 mm Hg (p less than 0.05) as did diastolic pressure from 97 to 85 mm Hg (p less than 0.01). Heart rate was insignificantly increased (72 to 75/min) while end-diastolic dimension and systolic shortening were unaltered. IVRT decreased from 99 to 82 msec (p less than 0.01) and both -VCF (-4.0 to -5.0 circ/sec, p less than 0.01) and % DRF (76 to 81%, p less than 0.05) increased, suggesting more rapid relaxation and augmented filling. Thus, nifedipine improves diastolic filling dynamics in hypertrophic cardiomyopathy and therefore appears to be useful for treatment of the nonobstructive form of hypertrophic cardiomyopathy.
D000328:Adult; D006328:Cardiac Catheterization; D006332:Cardiomegaly / Q000188:drug therapy*; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*
D011725:Pyridines; D009543:Nifedipine
Nifedipin in der Behandlung der hypertrophen, nicht-obstruktiven Kardiomyopathie.