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Effect of Diltiazem on Cardiac Function Assessed by Echocardiography and Neurohumoral Factors After Reperfused Myocardial Infarction Without Congestive Heart Failure

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Abstract

The purpose of this study was to examine the effect of diltiazem on cardiac function and neurohumoral factors (BNP, epinephrine, norepinephrine) after reperfused myocardial infarction without congestive heart failure (Killip class I). On the first day after myocardial infarction following reperfusion therapy patients were randomly assigned to diltiazem treatment (group 1, n = 33) or no treatment (group 2, n = 39). We then performed echocardiographic examinations on the patients and measured heart rate, mean blood pressure and neurohormones (BNP, epinephrine and norepinephrine). Follow-up evaluations of echocardiography were performed at 4 and 12 weeks and of neurohormones at 1 and 4 weeks after acute myocardial infarction. The highest peaks of plasma BNP, epinephrine, and norepinephrine levels were observed before treatment and decreased with time in both groups. After 4 weeks the level of plasma BNP in the diltiazem treatment group was lower than in the no treatment group [55 ± 3 pg/mL vs 85 ± 5 pg/mL (P < 0.05)]. Other neurohormones did not differ between groups. Fractional shortening (FS) and ejection fraction (EF)improved after myocardial infarction in both groups, but significantly more in the diltiazem group (P < 0.05) after 12 weeks of treatment. Changes in BNP correlated significantly with changes in left ventricular end systolic volumes, FS and EF. In this study, diltiazem significantly improved systolic function and reduced the level of plasma BNP after myocardial infarction, which suggest that diltiazem may have a beneficial effect on myocardial infarction without congestive heart failure.

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Authors and Affiliations

  1. Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Japan

    Norimasa Maki, Minoru Yoshiyama, Takashi Omura, Kazuhide Takeuchi & Junichi Yoshikawa

  2. Ikuwakai Memorial Hospital, Japan

    Takayoshi Yoshimura

  3. Baba Memorial Hospital, Japan

    Takahiko Kawarabayashi

  4. Tane General Hospital, Japan

    Kazuo Sakamoto

  5. Fuchu General Hospital, Japan

    Kazuyoshi Hirota

  6. Tukazaki Memorial Hospital, Japan

    Hidetaka Iida

Authors
  1. Norimasa Maki
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  2. Minoru Yoshiyama
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  3. Takashi Omura
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  4. Takayoshi Yoshimura
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  5. Takahiko Kawarabayashi
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  6. Kazuo Sakamoto
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  7. Kazuyoshi Hirota
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  8. Hidetaka Iida
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  9. Kazuhide Takeuchi
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  10. Junichi Yoshikawa
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Maki, N., Yoshiyama, M., Omura, T. et al. Effect of Diltiazem on Cardiac Function Assessed by Echocardiography and Neurohumoral Factors After Reperfused Myocardial Infarction Without Congestive Heart Failure. Cardiovasc Drugs Ther 15, 493–499 (2001). https://doi.org/10.1023/A:1013711619856

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