Acute haemodynamic effects of diltiazem in patients with recent Q-wave myocardial infarction

S. Ghio, S. De Servi, M. Ferrario, E. Poma, E. Bramucci, L. Angoli, G. Specchia

Research output: Contribution to journalArticle

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Abstract

The effects of diltiazem on left ventricular systolic and diastolic function were studied in 14 patients with a recent (12-20 days) Q-wave myocardial infarction. Left ventriculography with simultaneous recording of high-fidelity left ventricular pressure was performed in control conditions, and after i.v. administration of diltiazem (0.2 mg kg-1 as a bolus followed by constant infusion of 0.005 mg kg-1 min-1 lasting 8-10 min). After the administration of the drug, left ventricular systolic pressure decreased by 12.7% and mean circumferential wall stress by 14% (both P <0.01); the heart rate did not change; the ejection fraction increased by 9.6% (P <0.05) and maximum dP/dt/P by 11% (P <0.01). Quantitative segmental wall motion analysis showed that the beneficial effects of diltiazem on global left ventricular systolic function were associated with an increase in contraction in hypokinetic regions, where they were supplied by normal or diseased coronary vessels (both P <0.01). Left ventricular end-diastolic pressure decreased by 23.6% (P <0.05) and minimal diastolic pressure by 38% (P <0.05). Passive diastolic properties of the left ventricular chamber remained unaltered but isovolumic relaxation markedly improved; the T constant decreased 26% (P <0.01). Thus, in patients with a recent Q-wave myocardial infarction, the i.v. administration of diltiazem unloads the left ventricular chamber without showing depressant effects on myocardial contractility.

Original languageEnglish
Pages (from-to)740-745
Number of pages6
JournalEuropean Heart Journal
Volume9
Issue number7
Publication statusPublished - 1988

Fingerprint

Myocardial Infarction
Diltiazem
Hemodynamics
Acute
Ventricular Pressure
Blood Pressure
Diastolic Function
Contractility
Motion Analysis
Heart Rate
Left Ventricular Function
Vessel
Fidelity
Contraction
Coronary Vessels
Drugs
Myocardial infarction
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Physiology

Cite this

Acute haemodynamic effects of diltiazem in patients with recent Q-wave myocardial infarction. / Ghio, S.; De Servi, S.; Ferrario, M.; Poma, E.; Bramucci, E.; Angoli, L.; Specchia, G.

In: European Heart Journal, Vol. 9, No. 7, 1988, p. 740-745.

Research output: Contribution to journalArticle

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AU - Angoli, L.

AU - Specchia, G.

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N2 - The effects of diltiazem on left ventricular systolic and diastolic function were studied in 14 patients with a recent (12-20 days) Q-wave myocardial infarction. Left ventriculography with simultaneous recording of high-fidelity left ventricular pressure was performed in control conditions, and after i.v. administration of diltiazem (0.2 mg kg-1 as a bolus followed by constant infusion of 0.005 mg kg-1 min-1 lasting 8-10 min). After the administration of the drug, left ventricular systolic pressure decreased by 12.7% and mean circumferential wall stress by 14% (both P <0.01); the heart rate did not change; the ejection fraction increased by 9.6% (P <0.05) and maximum dP/dt/P by 11% (P <0.01). Quantitative segmental wall motion analysis showed that the beneficial effects of diltiazem on global left ventricular systolic function were associated with an increase in contraction in hypokinetic regions, where they were supplied by normal or diseased coronary vessels (both P <0.01). Left ventricular end-diastolic pressure decreased by 23.6% (P <0.05) and minimal diastolic pressure by 38% (P <0.05). Passive diastolic properties of the left ventricular chamber remained unaltered but isovolumic relaxation markedly improved; the T constant decreased 26% (P <0.01). Thus, in patients with a recent Q-wave myocardial infarction, the i.v. administration of diltiazem unloads the left ventricular chamber without showing depressant effects on myocardial contractility.

AB - The effects of diltiazem on left ventricular systolic and diastolic function were studied in 14 patients with a recent (12-20 days) Q-wave myocardial infarction. Left ventriculography with simultaneous recording of high-fidelity left ventricular pressure was performed in control conditions, and after i.v. administration of diltiazem (0.2 mg kg-1 as a bolus followed by constant infusion of 0.005 mg kg-1 min-1 lasting 8-10 min). After the administration of the drug, left ventricular systolic pressure decreased by 12.7% and mean circumferential wall stress by 14% (both P <0.01); the heart rate did not change; the ejection fraction increased by 9.6% (P <0.05) and maximum dP/dt/P by 11% (P <0.01). Quantitative segmental wall motion analysis showed that the beneficial effects of diltiazem on global left ventricular systolic function were associated with an increase in contraction in hypokinetic regions, where they were supplied by normal or diseased coronary vessels (both P <0.01). Left ventricular end-diastolic pressure decreased by 23.6% (P <0.05) and minimal diastolic pressure by 38% (P <0.05). Passive diastolic properties of the left ventricular chamber remained unaltered but isovolumic relaxation markedly improved; the T constant decreased 26% (P <0.01). Thus, in patients with a recent Q-wave myocardial infarction, the i.v. administration of diltiazem unloads the left ventricular chamber without showing depressant effects on myocardial contractility.

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