Hypertrophic Cardiomyopathy pp 148-157 | Cite as
Effect of Verapamil on Left Ventricular Isovolumic Relaxation Time and Regional Left Ventricular Filling in Hypertrophic Cardiomyopathy
Abstract
Hypertrophic obstructive and nonobstructive cardiomyopathy are often associated with an abnormal prolonged left ventricular isovolumic relaxation time and a disturbed left ventricular filling pattern [1–5]. Recent experimental studies revealed that calcium antagonists may improve impaired left ventricular relaxation caused by ischemia or hypoxia [6, 7]. Based on these experimental results, it was the purpose of the present study to examine whether the impaired left ventricular relaxation in patients with obstructive and nonobstructive hypertrophic cardiomyopathy can be improved by intravenous application of verapamil.
Keywords
Hypertrophic Cardiomyopathy Left Ventricular Filling Left Ventricular Relaxation Ventricular Relaxation Isovolumic Relaxation TimePreview
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References
- 1.Sanderson JE, Traill TA, St John Sutton MG, Brown DJ, Gibson DG, Goodwin JF (1978) Left ventricular relaxation and filling in hypertrophic cardiomyopathy. An echocardiographic study. Br Heart J 40: 596–601PubMedCrossRefGoogle Scholar
- 2.Sanderson JE, Gibson DG, Brown DJ, Goodwin JF (1977) Left ventricular filling in hypertrophic cardiomyopathy. An angiographic study. Br Heart J 39: 661–670PubMedCrossRefGoogle Scholar
- 3.Martin G, St John Sutton MG, Tajik AJ, Gibson DG, Brown DJ, Seward IB, Giuliani E (1978) Echocardiographic assessment of left ventricular filling and septal and posterior wall dynamics in idiopathic hypertrophic subaortic stenosis. Circulation 57: 512–520Google Scholar
- 4.Harmjanz D, Böttcher D, Scheitler CC (1971) Correlation of electrocardiogram pattern, shape of ventricular septum and isovolumic relaxation time in idiopathic hypertrophic subaortic stenosis. Br Heart J 13: 928–937CrossRefGoogle Scholar
- 5.Hanrath P, Mathey DG, Sigert R, Bleifeld W (1980) Left ventricular relaxation and filling pattern in different forms of left ventricular hypertrophy. An echocardiographic study. Am J Cardiol 45: 15–23PubMedCrossRefGoogle Scholar
- 6.Henry PD, Shuchleib R, Davis J, Weiss ES, Sobel BE (1977) Myocardial contracture and accumulation of mitochondrial calcium in ischemic rabbit heart. Am J Physiol 233/6: H 677–H 684Google Scholar
- 7.Verdow PD, Brown AH, Ten Cate FJ, Serruys PW (1979) Ventricular wall thickness changes during myocardial ischemia and after administration of Ca-antagonists (Abstr). In: Symposium quantification of myocardial ischemia, Goettingen, W Germany, May 13–15, 1979Google Scholar
- 8.Krebs W, Hanrath P, Bleifeld W, Effert S (1977) Rechnergestützte Auswertung von M-Mode-Echokardiogrammen. Herz/Kreislauf 9: 519–525Google Scholar
- 9.Hanrath P, Mathey DG, Kremer P, Sonntag F, Bleifeld W (1980) Effect of verapamil on left ventricular isovolumic relaxation time and regional left ventricular filling in hypertrophic cardiomyopathy. Am J Cardiol 45: 1258–1264PubMedCrossRefGoogle Scholar
- 10.Rodbard S, Rathews N (1975) Valve closure and the second heart sound. Circulation 52: 519–521PubMedGoogle Scholar
- 11.Leatham A, Leech 6 (1975) Observations on the relations between heart sounds and valve movement by simultaneous echo- and phonocardiography ( Abstr ). Br Heart J 37: 557Google Scholar
- 12.Hirschhield S, Liebman J, Boskat G, Borsmith C (1977) Intracardiac pressure-sound correlates of echographic aortic valve closure. Circulation 55: 602–604Google Scholar
- 13.Laniado S, Yellin E, Kottier M, Levy L, Stadler J, Terdiman R (1975) A study of the dynamic relations between the mitral echogram and phasic mitral flow. Circulation 51: 104–113PubMedGoogle Scholar
- 14.Chen W, Gibson D (1979) Relation of isovolumic relaxation to left ventricular wall movement in man. Br Heart J 42: 51–56PubMedCrossRefGoogle Scholar
- 15.Cohn PE, Liedtke A J, Senir J, Sonnenblick HE, Urschel CW (1972) Maximal rate of pressure fall (peak negative dp/dt) during ventricular relaxation. Cardiovasc Res 6: 263–267PubMedCrossRefGoogle Scholar
- 16.Weisfeldt ML, Seully HE, Frederiksen J, Rubenstein JJ, Pohost GM, Beierholm E, Bello AG, Daggelt WM (1974) Hemodynamic determinants of maximum negative dp/dt and periods of diastole. Am J Physiol 227: 613–621PubMedGoogle Scholar
- 17.Benchimol A, Ellis JG (1967) A study of the period of isovolumic relaxation in normal subjects and in patients with heart disease. Am J Cardiol 19: 196–206PubMedCrossRefGoogle Scholar
- 18.Grossman W, McLaurin LP (1976) Diastolic properties of the left ventricle. Ann Intern Med 84: 316–326PubMedGoogle Scholar
- 19.Papapietro HC, Coghlan W, Zissermann D, Rüssel RO, Rackley ChE, Rogers WJ (1979) Impaired maximal rate of left ventricular relaxation in patients with coronary artery disease and left ventricular dysfunction. Circulation 59: 984–990PubMedGoogle Scholar
- 20.Ferlinz J, Easthope JL, Aronow WJ (1979) Effects of Verapamil on myocardial performance in coronary disease. Circulation 59: 313–319PubMedGoogle Scholar
- 21.Singh BN, Roche AHG (1977) Effects of intraveneous verapamil on hemodynamics in patients with heart disease. Am Heart J 94: 593–599PubMedCrossRefGoogle Scholar
- 22.Fanburg BR, Finkel RM, Marjonosi A (1964) The role of calcium in the mechanism of relaxation of cardiac muscle. J Biol Chem 239: 2298–2306PubMedGoogle Scholar
- 23.Weber A, Herz R, Reiss J (1967) The nature of cardiac relaxaing factor. Biochem Biophys Acta 131: 188–194CrossRefGoogle Scholar
- 24.Katz AM, Repke DJ (1973) Calcium membrane interactions in the myocardium: effects of ouaborin, epinephine and 3/.5/ cyclic adenosine monophosphate. Am J Cardiol 31: 193–201PubMedCrossRefGoogle Scholar
- 25.Langer GA (1974) Ionic movements and the control of contraction in the mammalian myocardium. In: Langer GA, Brady AJ (eds) Wiley & Sons, New York, pp 193–218Google Scholar
- 26.McLaurin LP, Grossman W, Herdorn W (1975) Defective left ventricular relaxation during experimental myocardial ischemia (Abstr) Clin Res 23: 1964Google Scholar
- 27.Mathey D, Bleifeld W, Franken G (1974) Left ventricular relaxation and diastolic stiffness in experimental myocardial infarction. Cardiovasc Res 8: 583–592CrossRefGoogle Scholar
- 28.Frist WH, Palacias J, Powell WMJ (1978) Effect of hypoxia on myocardial relaxation in isometric cat papillary muscle. J Clin Invest 61: 1218–1224PubMedCrossRefGoogle Scholar
- 29.McLaurin LP, Rolette EL, Grossman W (1973) Impaired left ventricular relaxation during pacing induced ischemia. Am J Cardiol 32: 751–757PubMedCrossRefGoogle Scholar
- 30.Mann T, Brodie BR, Grossman W, McLaurin LP (1977) Effect of angina on left ventricular diastolic pressure-volume relationship. Circulation 55: 761–766PubMedGoogle Scholar
- 31.Mann T, Goldberg S, Mudge GH, Grossman W (1979) Factors contribution to altered left ventricular diastolic properties during angina pectoris. Circulation 59: 14–20PubMedGoogle Scholar
- 32.Grossman W, Mann JT (1978) Evidence impaired left ventricular relaxation during acute ischemia in man. Eur J Cardiol [Suppl] 7: 239–249Google Scholar
- 33.Nayler WG, Williams A (1978) Relaxation in heart muscle: some morphological and biochemical considerations. Eur J Cardiol [Suppl] 7: 35–50Google Scholar
- 34.Smith HJ, Goldstein RA, Griffith JM, Kent KM, Epstein SE (1976) Regional contractility. Selective depression of ischemic myocardium by verapamil. Circulation 54: 629–635PubMedGoogle Scholar
- 35.Smith HJ, Singh BN, Nisketh HD, Norris RM (1973) Effects of verapamil on infarct size following experimental coronary artery occlusion. Cardiovasc Res 9: 569–578CrossRefGoogle Scholar
- 36.Wende W, Bleifeld W, Nayler J, Stuhlen HW (1975) Reduction of the size of acute, experimental myocardial infarction by verapamil. Basic Res Cardiol 70: 198–208PubMedCrossRefGoogle Scholar
- 37.Nayler WG, Grau A, Stade A (1976) A protective effect of verapamil on hypoxia heart muscle. Cardiovasc Res 10: 650–662PubMedCrossRefGoogle Scholar
- 38.Nayler WG, Szeto J (1972) Effect of verapamil on contractility, oxygen utilization, and calcium exchangeability in mammalian heart muscle. Cardiovasc Res 6: 120–128PubMedCrossRefGoogle Scholar
- 39.Weishaar R, Ashikawa K, Bingy RJ (1979) Effect of diltiazem, a calcium antagonist on myocardial ischemia. Am J Cardiol 43: 1137–1143PubMedCrossRefGoogle Scholar
- 40.Kaltenbach M, Hopf R, Kellner M (1976) Calciumantagonistische Therapie bei hypertropher-obstruktiver Kardiomyopathie. Dtsch Med Wochenschr 101: 1284–1287PubMedCrossRefGoogle Scholar
- 41.Rosing DR, Kent KM, Maron J, Epstein SE (1979) Verapamil treatment: a new approach to the pharmacologic treatment of hypertrophic cardiomyopathy. II. Effects on exercise capacity and symptomatic status. Circulation 60: 1208PubMedGoogle Scholar
- 42.Kaltenbach M, Hopf R, Kober G, Bussmann D, Kellner M, Petersen Y (1979) Treatment of hypertrophic obstructive cardiomyopathy with verapamil. Br Heart J 42: 35–42PubMedCrossRefGoogle Scholar