Regional coronary hemodynamic effects of diltiazem in man

Carlo Vigorito, Arturo Giordano, Lorenzo De Caprio, Vincenzo Canonico, Paolo Ferraro, Nicola Farese, Paolo Silvestri, Maurizio Catanzaro, Franco Rengo

Research output: Contribution to journalArticlepeer-review

Abstract

We evaluated the changes in regional coronary hemodynamics induced by diltiazem, 0.25 mg/kg intravenously, in nine patients with 75% to 90% diameter stenosis of the left anterior descending coronary artery (LAD) (group 1) and in 10 patients with 100% occlusion of the LAD and collaterais to the distal LAD (group 2). Although diltiazem induced similar changes in systemic hemodynamics in the two groups, a decrease in anterior coronary vascular resistance (ACVR) and an increase in great cardiac vein flow (GCVF) were observed after administration of diltiazem in all patients in group 1 but in only 6 of 10 patients in group 2 (subgroup 2B). ACVR increased and GCVF decreased after administration of diltiazem in 4 of 10 patients in group 2 (subgroup 2A). Clinicoangiographic characteristics, origin of collaterals, and diltiazem-induced changes in systemic hemodynamics were similar in subgroups 2A and 2B. Thus diltiazem increases coronary flow distal to a stenotic coronary artery but can decrease regional coronary flow and increase regional coronary resistance in a minority of patients with an occluded coronary artery supplied by collaterals, probably through a steal mechanism.

Original languageEnglish
Pages (from-to)799-805
Number of pages7
JournalAmerican Heart Journal
Volume116
Issue number3
DOIs
Publication statusPublished - 1988

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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