Effects of verapamil on myocardial performance in coronary disease.
Reads0
Chats0
TLDR
In patients with CAD, the intrinsic negative inotropic effect of verapamil is of negligible importance because its potent vasodilatory properties more than compensate for any intrinsic decrease in LV contractility, and thereby improve the overall cardiac function.Abstract:
Verapamil, a calcium antagonist, has been used extensively for treatment of cardiac arrhythmias. Concern persists, however, that it may seriously depress myocardial function in cardiac patients. To investigate this possibility, 20 patients with coronary artery disease (CAD) but no heart failure were given intravenous verapamil (0.1 mg/kg bolus, followed by 0.005 mg/kg/min infusion), and studied hemodynamically and angiographically. Verapamil markedly lowered mean aortic pressure (94 +/- 17 to 82 +/- 13 mm Hg, p less than 0.0005) and systemic vascular resistance (1413 +/- 429 to 1069 +/- 235 dyn-sec-cm5, p less than 0.0005). Simultaneously, all indices of left ventricular (LV) performance greatly improved: cardiac index rose from 2.8 +/- 0.6 to 3.1 +/- 0.7 1/min/m2 (p less than 0.0005), mean velocity of circumferential fiber shortening increased from 0.85 +/- 0.39 to 0.97 +/- 0.46 circ/sec (p less than 0.01), and ejection fraction improved from 55 +/- 16 to 61 +/- 18% (p less than 0.01). No significant cha...read more
Citations
More filters
Journal ArticleDOI
Comparative pharmacology of calcium antagonists: Nifedipine, verapamil and diltiazem
TL;DR: Nifedipine is a potent, long-acting vasodilator that has proved highly efficacious in relieving anginal symptoms caused by coronary vasospasm, and its value as an antiarrhythmic agent remains to be delineated.
Journal ArticleDOI
Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders. Part II: Hemodynamic Effects and Clinical Applications
TL;DR: The negative inotropic effects of verapamil are valuable in improving the symptoms and hemodynamic disturbances of hypertrophic cardiomyopathy and the role of these agents in treating arterial hypertension, unstable angina pectoris, acute myocardial infarction, and ischemia during cardiopulmonary bypass needs to be determined.
Journal ArticleDOI
Verapamil. An updated review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension.
Donna McTavish,Eugene M. Sorkin +1 more
TL;DR: Evidence from clinical studies supports the role of oral verapamil as an effective and well-tolerated first-line treatment for the management of patients with mild to moderate essential hypertension and it may be used in preference to beta-blockers in patients with asthma or chronic obstructive airway disease.
Journal ArticleDOI
Therapeutic implications of slow-channel blockade in cardiocirculatory disorders.
TL;DR: Evidence indicates that certain slow-channel antagonists may be useful in other cardiocirculatory disorders, such as acute pulmonary edema, acute hypertensive emergencies and obstructive cardiomyopathies, whose indications, if confirmed, will broaden the clinical usefulness of this class of compounds.
Journal ArticleDOI
Wide Complex Tachycardia: Misdiagnosis and Outcome After Emergent Therapy
TL;DR: The extent and consequence of misdiagnosis of wide complex tachycardia (QRS, 120 ms or more; heart rate, 100 or more beats/min) presenting emergently were assessed and Verapamil is commonly administered in these circumstances and is frequently associated with a poor outcome.
References
More filters
Journal ArticleDOI
Physiologic basis for assessing critical coronary stenosis : Instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve
TL;DR: Flow response and regional distribution during coronary hyperemia caused by Hypaque are quantitative measures for physiologically assessing critical coronary stenosis and flow reserve with potential applicability to patients.
Journal ArticleDOI
Localized disorders in myocardial contraction. Asynergy and its role in congestive heart failure.
TL;DR: The pattern of left ventricular contraction is described as a "series of sequential fractionate contractions of muscle bundles" and the possibility that unco-ordinated contraction of the heart results from a combination of normal and abnormal muscle has received little attention.
Journal ArticleDOI
Differentiation of the transmembrane Na and Ca channels in mammalian cardiac fibres by the use of specific inhibitors
TL;DR: Verapamil and D 600 differ in this respect from common local anesthetic compounds such as xylocaine (lidocaine) or procaine which interfere much more with the transmembrane Na conductivity than with the Ca conductivity.
Journal ArticleDOI
Vasodilator therapy of cardiac failure: (first of two parts).
Jay N. Cohn,Joseph A. Franciosa +1 more
TL;DR: The symptoms of cardiac failure are related to some combination of circulatory congestion and low cardiac output and therapy for cardiac failure has traditionally involved the Administration of an inotropic drug to increase the contractile force of the heart and the administration of a diuretic to increasing the renal excretion of salt and water.
Journal ArticleDOI
Conduction of the Cardiac Impulse
TL;DR: The results prove that conduction delays great enough to permit re-entry can occur in short segments of Purkinje fibers subjected to high K+.