Myocardial fibrosis attenuates the effect of cibenzoline on left ventricular diastolic function in patients with hypertrophic cardiomyopathy.
The aim of this study was to investigate the relationship between late gadolinium enhancement (LGE) and the effect of cibenzoline (CBZ) on left ventricular (LV) diastolic function in hypertrophic cardiomyopathy (HCM) patients. Echocardiography before and after intravenous CBZ (1.4 mg/kg over 5 minutes) and magnetic resonance imaging (MRI) were performed in 22 consecutive patients with HCM [mean age: 65 ± 14 years, obstructive HCM: 14, nonobstructive HCM (HNCM): 8]. The extent of LGE (%LGE = LGE volume/total LV volume) was obtained by contrast-enhanced MRI using custom software. LGE was observed in 19 patients (mean %LGE = 5.1% ± 3.9%). The propagation velocity of LV early filling flow (Vp) increased significantly in patients with obstructive HCM (26 ± 7 to 36 ± 14 cm/s, P = 0.001) and nonobstructive HCM (25 ± 9 to 36 ± 16 cm/s, P = 0.007). A significant negative correlation was observed between the change in Vp and %LGE in patients with HCM (r = 20.542, P = 0.009). Less extensive myocardial fibrosis, as demonstrated by LGE on contrast-enhanced MRI, may predict the ability of CBZ to improve LV diastolic function in HCM.
Department of Cardiology, Kitaishikai Hospital, Ozu, Japan.
Makoto
M
Saito
Hideki
H
Okayama
Toyofumi
T
Yoshii
Go
G
Hiasa
Takumi
T
Sumimoto
Shinji
S
Inaba
Kazuhisa
K
Nishimura
Katsuji
K
Inoue
Akiyoshi
A
Ogimoto
Yuji
Y
Shigematsu
Jun-ichi
J
Funada
Mareomi
M
Hamada
Jitsuo
J
Higaki
D002312:Cardiomyopathy, Hypertrophic / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D005260:Female; D005355:Fibrosis; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology*
D007093:Imidazoles; C032151:cifenline