Cibenzoline improves coronary flow velocity reserve in patients with hypertrophic obstructive cardiomyopathy.
The effect of cibenzoline, a class-Ia antiarrhythmic drug, on coronary flow velocity reserve (CFVR) was examined in patients with hypertrophic cardiomyopathy using transthoracic Doppler echocardiography. Coronary flow velocity reserve was assessed in 11 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 12 patients with hypertrophic nonobstructive cardiomyopathy (HNCM), before and after the intravenous administration of cibenzoline (1 mg/kg). Coronary hyperemia was induced by an intravenous infusion of adenosine triphosphate and CFVR was calculated as the ratio of hyperemic to basal mean coronary diastolic flow velocity. At baseline, CFVR was significantly correlated with left ventricular outflow tract pressure gradient (LVPG) in patients with HOCM (r = 0.67, P < 0.03). In patients with HOCM, administration of cibenzoline significantly improved impaired CFVR (2.0 +/- 0.8 to 3.0 +/- 1.0, P < 0.001), and reduced LVPG (55 +/- 30 to 23 +/- 18 mmHg, P < 0.001), while CFVR remained unchanged in patients with HNCM (2.6 +/- 0.9 to 2.9 +/- 0.8, P not significant). Cibenzoline not only reduces LVPG but also improves CFVR in patients with HOCM. In addition left ventricular outflow obstruction plays an important role in impaired coronary circulation in patients with HOCM.
Sekine
Tai
T
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Daimon
Masao
M
Hasegawa
Rei
R
Teramoto
Kiyomi
K
Kawata
Takayuki
T
Tanaka
Nobuhiro
N
Takei
Yasuhiro
Y
Takazawa
Kenji
K
Yoshida
Katsuya
K
Komuro
Issei
I
D000255:Adenosine Triphosphate; D000368:Aged; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000187:drug effects*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D003326:Coronary Circulation / Q000187:drug effects*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced; D007093:Imidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects; D014694:Ventricular Outflow Obstruction / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D000255:Adenosine Triphosphate; C032151:cifenline