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INFLUENCE OF INTRAVENOUS DILTIAZEM ON LEFT-VENTRICULAR FUNCTION IN PATIENTS WITH SEVERE CORONARY-ARTERY DISEASE AT REST AND DURING PACING, MONITORED BY COMPUTER-PROCESSED NUCLEAR PROBE AND TIP-MANOMETER DATA

VANDIJK, RB., BLANKSMA, PK., VANGILST, WH. & LIE, KI., Aug-1993, In : Journal of Cardiovascular Pharmacology. 22, 2, p. 215-220 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

The influence of intravenous diltiazem on hemodynamics and left ventricular function indices was studied in 14 patients with severe coronary artery disease at rest and during atrial pacing. We used a tip manometer catheter for recording left ventricular pressure tracings and a nuclear probe for measuring left ventricular volume changes. Infusion of diltiazem at rest resulted in an increase in left ventricular enddiastolic volume (+ 16%, p <0.0001); allother parameters did not differ significantly from baseline values. Angina pectoris occurred in all patients during atrial pacing before diltiazem infusion (ContrP); during pacing after diltiazem infusion (DiltP) only four patients became symptomatic (at the same pacing rates). Other differences between the two pacing studied and their baseline measurement were mean arterial pressure (ContrP: +13%, p <0.001; DiltP: +11% p <0.001), pulmonary wedge pressure (ContrP: +54%, p = 0.019; DiltP: NS), left ventricular enddiastolic pressure (ContrP: +40%, p <0.005; DiltP: NS), left ventricular enddiastolic volume (ContrP: -19%, p = 0.001; DiltP: -33%, p = 0.0001), left ventricular ejection fraction (ContrP: -20%, p = 0.039: DiltP: NS), maximum rate of rise of left ventricular systolic pressure (ContrP: +22%, p = 0.00 1; DiltP: +20%, p = 0.03), time constant of relaxation (ContrP: +40%, p = 0.001; DiltP +8%, p = 0.047), stiffness constant of the diastolic pressure-volume relationship (ContrP: +157%, p = 0.0001; DiltP: +132%, p = 0.001), and left ventricular systolic work (ContrP: -35%, p = 0.0001; DiltP -46%, p = 0.0001). When comparing the data collected during pacing before and after diltiazem infusion, we found a significant decrease in the time constant of relaxation (Tr) (-17%, p = 0.023). The study results demonstrate that diltiazem has favorable hemodynamic effects and that it reduces the ischemia-induced early diastolic relaxation disturbances in patients with coronary artery disease.

Original languageEnglish
Pages (from-to)215-220
Number of pages6
JournalJournal of Cardiovascular Pharmacology
Volume22
Issue number2
Publication statusPublished - Aug-1993

    Keywords

  • ANGINA PECTORIS, DILTIAZEM, CALCIUM ANTAGONISTS, LEFT VENTRICULAR FUNCTION, STABLE ANGINA-PECTORIS, DIASTOLIC FUNCTION, PERFORMANCE, RELAXATION, STIFFNESS, EXERCISE, EFFICACY, BLOCKADE, VOLUMES

ID: 6355780