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Influence of verapamil therapy on left ventricular performance at rest and during exercise in hypertrophic cardiomyopathy

Authors
Journal
The American Journal of Cardiology
0002-9149
Publisher
Elsevier
Publication Date
Volume
52
Issue
5
Identifiers
DOI: 10.1016/0002-9149(83)90023-1
Disciplines
  • Medicine

Abstract

Abstract To determine the hemodynamic effect of verapamil at rest and during exercise, 18 patients with hypertrophic cardiomyopathy were studied before and after 7 weeks of treatment with oral verapamil (maximal dose, 720 mg/day). At rest and at peak exercise, verapamil produced a significant increase in left ventricular (LV) systolic performance in terms of stroke volume index (rest, from 43 ± 11 to 53 ± 11 ml/m 2, p < 0.001; exercise, from 46 ± 11 to 51 ± 10 ml/m 2, p < 0.01), whereas heart rate decreased (rest, from 81 ± 14 to 70 ± 11 min −1, p < 0.001; exercise, from 150 ± 21 to 141 ± 18 min −1, p < 0.01). Cardiac index at rest and during exercise remained unchanged. Systolic vascular resistance did not change at rest, but decreased significantly during exercise (974 ± 243 to 874 ± 174 dynes s cm −5; p < 0.05). After verapamil administration, pulmonary artery pressures did not change at rest, but decreased significantly during exercise. This was probably due to a shift in the LV pressure-volume relation. The improvement in LV hemodynamics was associated with a significant increase in exercise capacity. The findings of this study indicate that in patients with hypertrophic cardiomyopathy, hemodynamic improvement at rest and during exercise can be achieved by chronic administration of verapamil.

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