Effect of intravenous administration of cibenzoline on left ventricular diastolic pressures in patients with hypertrophic cardiomyopathy: its relationship to transmitral Doppler flow profiles.
BACKGROUND
Cibenzoline is able to improve left ventricular (LV) diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM), but the exact mechanism remains to be determined.


RESULTS
The present study was designed to elucidate the effect of intravenous administration of 1.4 mg/kg of cibenzoline on aortic and LV pressures, and transmitral Doppler flow pattern in 7 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 9 patients with hypertrophic nonobstructive cardiomyopathy (HNCM). Before and at the end of the administration, aortic and LV pressures, LV pressure gradient (LVPG) and transmitral Doppler velocity profiles were examined. After the administration of cibenzoline, LV minimal and end-diastolic pressures decreased from 9+/-4 mmHg to 1+/-5 mmHg (p=0.0049) and from 22+/-7 mmHg to 14+/-5 mmHg (p=0.0106) in patients with HOCM, and from 9+/-5 mmHg to 5+/-3 mmHg (p=0.0036) and from 20+/-6 mmHg to 14+/-3 mmHg (p=0.0033) in patients with HNCM. LVPG decreased in all patients with HOCM. E-wave velocity increased, A-wave velocity decreased, and thus the E/A ratio increased from 0.77+/-0.29 to 1.20+/-0.48 (p=0.0004).


CONCLUSIONS
Reduction of LV diastolic pressures by intravenous administration of cibenzoline may be related to an improvement in the E/A ratio in patients with HCM.
Hamada
Mareomi
M
Division of Cardiology, Uwajima City Hospital, Uwajima, Japan. mhamada@uwajima-mh.go.jp
Aono
Jun
J
Ikeda
Shuntaro
S
Watanabe
Kouki
K
Inaba
Shinji
S
Suzuki
Jun
J
Ohtsuka
Tomoaki
T
Shigematsu
Yuji
Y
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D009320:Atrial Natriuretic Factor / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy* / Q000503:physiopathology*; D002395:Catecholamines / Q000097:blood; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000503:physiopathology*
D000889:Anti-Arrhythmia Agents; D002395:Catecholamines; D007093:Imidazoles; D009320:Atrial Natriuretic Factor; C032151:cifenline