Influence of intravenous diltiazem on left ventricular function in patients with severe coronary artery disease at rest and during pacing, monitored by computer-processed nuclear probe and tip-manometer data.
The influence of intravenous diltiazem on hemodynamics and left ventricular function indices was studied in 14 patients with severe coronary artery disease at rest and during atrial pacing. We used a tip manometer catheter for recording left ventricular pressure tracings and a nuclear probe for measuring left ventricular volume changes. Infusion of diltiazem at rest resulted in an increase in left ventricular enddiastolic volume (+16%, p < 0.0001); all other parameters did not differ significantly from baseline values. Angina pectoris occurred in all patients during atrial pacing before diltiazem infusion (ContrP); during pacing after diltiazem infusion (DiltP) only four patients became symptomatic (at the same pacing rates). Other differences between the two pacing studied and their baseline measurement were mean arterial pressure (ContrP: +13%, p < 0.001; DiltP: +11% p < 0.001), pulmonary wedge pressure (ContrP: +54%, p = 0.019; DiltP: NS), left ventricular enddiastolic pressure (ContrP: +40%, p < 0.005; DiltP: NS), left ventricular enddiastolic volume (ContrP: -19%, p = 0.001; DiltP: -33%, p = 0.0001), left ventricular ejection fraction (ContrP: -20%, p = 0.039; DiltP: NS), maximum rate of rise of left ventricular systolic pressure (ContrP: +22%, p = 0.001; DiltP: +20%, p = 0.03), time constant of relaxation (ContrP: +40%, p = 0.001; DiltP +8%, p = 0.047), stiffness constant of the diastolic pressure-volume relationship (ContrP: +157%, p = 0.0001; DiltP: +132%, p = 0.001), and left ventricular systolic work (ContrP: -35%, p = 0.0001; DiltP -46%, p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
van Dijk
R B
RB
Department of Cardiology (Thorax Centre) University Hospital Groningen, The Netherlands.
Blanksma
P K
PK
van Gilst
W H
WH
Lie
K I
KI
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy; D001794:Blood Pressure / Q000187:drug effects; D002304:Cardiac Pacing, Artificial; D003201:Computers; D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology; D004110:Diltiazem / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D004566:Electrodes; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008365:Manometry; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000187:drug effects*
D004110:Diltiazem