[Nifedipine in hypertrophic obstructive cardiomyopathy].
The effects of nifedipine on left-ventricular dynamics were assessed in 6 patients with hypertrophic obstructive cardiomyopathy (HOCM). After intravenous infusion of 3 mg nifedipine the mean aortic pressure decreased from 100 +/- 14 to 85 +/- 8 mm Hg (P less than 0.001). Heart rate increased from 70 +/- 5 to 93 +/- 5 beats per minute (P less than 0.001). This led to an increase of cardiac index from 3.0 +/- 0.5 to 3.8 +/- 0.9 l/min . m2 (P less than 0.01), whereas the stroke volume index decreased from an average of 49 +/- 11 to 42 +/- 12 ml/m2 (P less than 0.05). A marked diminution of outflow obstruction was demonstrable in 3 patients with intraventricular pressure gradients. The left-ventricular enddiastolic pressure rose from 14 +/- 3 to 18 +/- 6 mm Hg (P less than 0.02) in all patients. This effect was accompanied by a clear-cut coronary dilatation, evidenced by an increase of oxygen saturation in the coronary sinus from 29 +/- 4 to 54 +/- 9% (P less than 0.001). Thus nifedipine leads to diminished outflow obstruction and concomitant increase of cardiac output in hypertrophic cardiomyopathy. Inhibition of contraction does not seem to be compensated by peripheral effects. Coronary dilatation demonstrable in HOCM patients permits protection against coronary spasms and thus an additional antianginous effects.
D000293:Adolescent; D000328:Adult; D001011:Aorta; D001794:Blood Pressure; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy* / Q000503:physiopathology; D003331:Coronary Vessels; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D011725:Pyridines / Q000627:therapeutic use*; D013318:Stroke Volume
D011725:Pyridines; D009543:Nifedipine; D010100:Oxygen
Nifedipin bei hypertrophisch obstruktiver Kardiomyopathie.