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Titolo:
SALUTARY EFFECT OF DISOPYRAMIDE ON LEFT-VENTRICULAR DIASTOLIC FUNCTION IN HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY
Autore:
MATSUBARA H; NAKATANI S; NAGATA S; ISHIKURA F; KATAGIRI Y; OHE T; MIYATAKE K;
Indirizzi:
OKAYAMA UNIV,SCH MED,DEPT PHYSIOL 2,2-5-1 SHIKATA CHO OKAYAMA 700 JAPAN NATL CARDIOVASC CTR,DEPT MED,DIV CARDIOL SUITA OSAKA JAPAN
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 3, volume: 26, anno: 1995,
pagine: 768 - 775
SICI:
0735-1097(1995)26:3<768:SEODOL>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
SYSTOLIC ANTERIOR MOTION; MITRAL-VALVE; RELAXATION; PROPRANOLOL; VERAPAMIL; MECHANISM; GRADIENT; STATES; SITE; LOAD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
H. Matsubara et al., "SALUTARY EFFECT OF DISOPYRAMIDE ON LEFT-VENTRICULAR DIASTOLIC FUNCTION IN HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY", Journal of the American College of Cardiology, 26(3), 1995, pp. 768-775

Abstract

Objectives. The purpose of this study was to estimate the effect of disopyramide on left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy. Background. Although disopyramide has been reported to lessen clinical symptoms in patients with hypertrophic obstructive cardiomyopathy, few data exist regarding its effect on diastolic function in these patients. Methods. Thirteen patientswith hypertrophic cardiomyopathy (six with and seven without left ventricular outflow obstruction) were examined, Before and after intravenous disopyramide, hemodynamic and angiographic studies were performed. Results. In patients with outflow obstruction, pressure gradient at the outflow tract decreased from a mean +/- SD of 100 +/- 45 to 26 +/- 33 mm Hg (p < 0.01). Although systolic function was similarly impairedin both groups, the time constant of left ventricular pressure decay (tau) shortened from 56 +/- 10 to 44 +/- 8 ms (p < 0.01) and the constant of left ventricular chamber stiffness (kc) decreased from 0.049 +/- 0.017 to 0.038 +/- 0.014 m(2)/ml (p < 0.01) only in patients with outflow obstruction, Shortening in tau correlated best with decrease in left ventricular systolic pressure (r = 0.84, p < 0.01). In contrast, tau was prolonged from 52 +/- 10 to 64 +/- 11 ms (p < 0.01) and kc wasunchanged in patients without outflow obstruction. Conclusions. The primary effects of disopyramide on the hypertrophied left ventricle were negative inotropic and negative lusitropic. However, left ventricular diastolic properties in patients with outflow obstruction were improved with a decrease in outflow pressure gradient. Relief of clinical symptoms in hypertrophic obstructive cardiomyopathy with disopyramide might be due in part to improvement of diastolic function, which appears secondary to the reduction in ventricular afterload.

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Documento generato il 23/09/20 alle ore 12:03:47