Portal de Periódicos da CAPES

Verapamil Therapy: A New Approach to Pharmacologic Treatment of Hypertrophic Cardiomyopathy

1980; Elsevier BV; Volume: 78; Issue: 1 Linguagem: Inglês

10.1378/chest.78.1.239

1931-3543

Douglas R. Rosing, Kenneth M. Kent, Barry J. Moron, John R. Condit, Stephen E. Epstein,

Advanced battery technologies research

The hemodynamic and clinical effects of verapamil administration were examined in patients with hypertrophic cardiomyopathy. Infusion of 0.021 mg/kg/min of verapamil decreased the basal left ventricular outflow tract gradient from 94 ± 14 to 49 ± 14 mm Hg, while cardiac index increased from 2.5 ± 0.2 to 2.8 ± 0.2 L/min/sq m. Orally administered, 80 or 120 mg four times daily (QID), increased exercise capacity relative to placebo by 26 percent (1.6 ± 0.5 minute; p < 0.005) and propranolol, 40 or 80 mg QID, Increased it by 21 ± 8 percent (1.3 ± 0.5 minute, p < 0.025). Nine patients considered their symptomatic status "best" while receiving verapamil, seven while receiving placebo, and only three while receiving propranolol Seventy-three patients have been discharged from the hospital receiving longterm verapamil therapy, and 49 have reported continuing symptomatic benefit with many showing improved exercise capacity up to two years later. Thus, verapamil can improve exercise capacity and symptomatic status in certain patients with hypertrophic cardiomyopathy, thereby providing physicians with a new therapeutic agent for the treatment of this disorder. The hemodynamic and clinical effects of verapamil administration were examined in patients with hypertrophic cardiomyopathy. Infusion of 0.021 mg/kg/min of verapamil decreased the basal left ventricular outflow tract gradient from 94 ± 14 to 49 ± 14 mm Hg, while cardiac index increased from 2.5 ± 0.2 to 2.8 ± 0.2 L/min/sq m. Orally administered, 80 or 120 mg four times daily (QID), increased exercise capacity relative to placebo by 26 percent (1.6 ± 0.5 minute; p < 0.005) and propranolol, 40 or 80 mg QID, Increased it by 21 ± 8 percent (1.3 ± 0.5 minute, p < 0.025). Nine patients considered their symptomatic status "best" while receiving verapamil, seven while receiving placebo, and only three while receiving propranolol Seventy-three patients have been discharged from the hospital receiving longterm verapamil therapy, and 49 have reported continuing symptomatic benefit with many showing improved exercise capacity up to two years later. Thus, verapamil can improve exercise capacity and symptomatic status in certain patients with hypertrophic cardiomyopathy, thereby providing physicians with a new therapeutic agent for the treatment of this disorder.