Effects of nifedipine on left venticular diastolic dysfunction after myocardial infarction
In order to assess the effects of nifedipine on left ventricular diastolic abnormalities, 26 patients (mean age 52 year, range 42–66) were studied 10 days after a first myocardial infarction, at rest and during handgrip by Doppler examination. The time-velocity integral for the rapid (E) and atrial (A) filling phases and the E/A ration were used; stroke volume was calculated as the aortic time-velocity integral times the cross-sectional valvular area. Twenty age-matched normal subjects constituted the controls.
Twenty-one patients had a reversal of the early to late diastolic filling pattern; five patients had a restrictive pattern. Nifedipine normalized left ventricular filling in patients with a reverse pattern, both at rest and during handgrip. Moreover, these patients showed a descending left ventricular function curve by relating at rest and handgrip values of cardiac index and the E/A ratio. After nifedipine, these study patients showed an ascending left ventricular curve, similar to that of normal subjects, with an increase in cardiac index and a slight decrease in the E/R ratio. No beneficial effects were detectable in patients with a restrictive pattern of left ventricular filling.
Key Wordsnifedipine diastolic function Doppler echocardigraphy
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- 4.Vissner CA, Koning H, Delemarre B. Pulsed-Doppler derived mitral inflow velocity in acute myocardial infarction: An early prognostic indication.J Am Coll Cardiol 1986;7:136A.Google Scholar
- 5.Scognamiglio R, Fasoli G, Miraglia G. Determinants of left ventricular remodeling after myocardial infarction. In:Computers in cardiology. 1989:89–97.Google Scholar
- 6.Fisher DC, Voyles WF, Sikes W. Left ventricular filling patterns during ischemia: An echo Doppler study in open chest dogs.J Am Coll Cardiol 1985;5:426A.Google Scholar
- 9.Drinkovic N, Wisenbaugh T, Nissen SE. Sensitivity and specificity of transmitral flow velocity measurement in detecting impaired left ventricular compliance.Circulation 1986;74:II46.Google Scholar
- 12.Danford DA, Huhta JC, Murphy DJ, Doppler echocardiographic approaches to ventricular diastolic function.Echocardiography 1986;3:33–41.Google Scholar