title: Impact of cilostazol on left ventricular geometry and function: assessment by tissue Doppler imaging and two-dimensional speckle-tracking echocardiography.
abstract: OBJECTIVE
  Cilostazol, a type III phosphodiesterase inhibitor, is an antiplatelet agent with vasodilating properties. Positive inotropic and chronotropic effects are frequently observed with cilostazol, but there are few reports on the influence of cilostazol on left ventricular function. The aim of this study was to assess this effect using tissue Doppler imaging (TDI) and two-dimensional speckle-tracking echocardiography (2D-STE).
  
  
  METHODS
  Thirty-five patients with normal left ventricular ejection fraction were enrolled in the study. Left ventricular cardiac function was assessed by TDI and 2D-STE before and after oral administration of cilostazol. Peak strain was defined using the peak radial strain (PRS), peak circumferential strain (PCS) and peak longitudinal strain (PLS). Time to peak strain was defined based on the times to PRS, PCS, and PLS, as T-PRS, T-PCS, and T-PLS, respectively.
  
  
  RESULTS
  After cilostazol administration, there were significant decreases in the left ventricular end-diastolic and end-systolic diameters (47.3 ± 5.2 vs. 43.3 ± 4.9 mm, P < 0.0001; 29.3 ± 6.4 vs. 26.0 ± 5.5 mm, P < 0.0001, respectively), and significant increases in the left ventricular ejection fraction (70.6 ± 9.5 vs. 72.7 ± 7.8%, P = 0.0381) and peak systolic annular velocity (7.9 ± 1.7 vs. 9.5 ± 3.1 cm/sec, P < 0.0001). PRS, PCS, and PLS all increased significantly and T-PRS, T-PCS, and T-PLS all decreased significantly after cilostazol administration.
  
  
  CONCLUSIONS
  Positive inotropic and chronotropic effects of cilostazol were found based on assessment by TDI and 2D-STE. We suggest that periodic echocardiographic assessment should be performed before and after oral administration of cilostazol.
authors.affiliation: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. hisao_yskw@kmh.biglobe.ne.jp
authors.forename: Hisao
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Go
authors.initials: G
authors.lastname: Hashimoto
authors.forename: Takenori
authors.initials: T
authors.lastname: Otsuka
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sugi
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D000077407:Cilostazol; D015897:Comorbidity; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D016014:Linear Models; D008297:Male; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D058987:Phosphodiesterase 3 Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D058987:Phosphodiesterase 3 Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol