Open AccessEffect of calcium antagonists on cardiac performance in patients with dilatative cardiomyopathy evaluated by noninvasive methods
Author(s) -
Maurer E.,
Nicoletti R.,
Brandt D.,
Klein W.
Publication year - 1983
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960060809
Subject(s) - diltiazem , verapamil , medicine , ejection fraction , cardiology , cardiomyopathy , cardiac index , diastole , nifedipine , cardiac output , anesthesia , hemodynamics , heart failure , calcium , blood pressure
We present 14 patients with dilatative cardiomyopathy, proven by hemodynamic and angiographic assessment who received in a single‐blind, randomized study, equipotent doses of the three calcium blockers: verapamil (0.1 mg/kg i.v., followed by an infusion of 0.01 mg/kg/min), nifedipin (20 mg sublingually), or diltiazem (0.2 mg/kg i.v., followed by infusion of 0.02 mg/kg/min). Before and after treatment in 8 patients systolic time intervals were recorded with an AVL‐Myocard‐Check (Q‐S 2 , pre‐ejection period, left ventricular ejection time, and pre‐ejection period/left ventricular ejection time) and end‐systolic and end‐diastolic diameter, fractional shortening, and circumferential fiber shortening velocity were measured by M‐mode echocardiography. In another 6 patients radionuclide ventriculography was performed before and after each treatment (ejection fraction, cardiac index). PEP/LVET increased slightly after verapamil (+15%) and decreased after nifedipin (—5%) and diltiazem (—3%), the changes being not significant. Fractional shortening and circumferential fiber shortening velocity however, decreased after verapamil (‐5%, resp. ‐15%) and increased after nifedipin (+14%, resp. +25%) and after diltiazem (+23%, resp. +16%). In the radionuclide studies ejection fraction increased after verapamil (+9%), nifedipin (+14%), and diltiazem (+13%), while cardiac index remained unchanged with verapamil and nifedipin and increased with diltiazem (+14%). In conclusion there are no significant changes in myocardial performance with the calcium blockers verapamil, nifedipin, and diltiazem. However, under verapamil there is a tendency to deterioration of myocardial performance, while it was slightly improved after nifedipin and diltiazem. Calcium antagonists may be used safely, therefore, also in patients with impaired myocardial performance.