Regional left ventricular asynchrony and impaired global left ventricular filling in hypertrophic cardiomyopathy

Effect of verapamil

R. O. Bonow, D. F. Vitale, B. J. Maron, S. L. Bacharach, T. M. Frederick, M. V. Green

Research output: Contribution to journalArticle

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Abstract

Left ventricular relaxation and filling are impaired in many patients with hypertrophic cardiomyopathy. To investigate the influence of regional heterogeneity on these global abnormalities, 48 patients with hypertrophic cardiomyopathy and sinus rhythm were studied by radionuclide angiography before and after 1 to 2 weeks of verapamil therapy (320 to 640 mg/day, median 480). Left ventricular regional function was assessed by subdividing the ventricular region of interest into 20 sectors and into four quadrants from which regional time-activity curves were derived. Diastolic asynchrony was measured as the regional variation in timing between minimal volume and peak filling rate, and heterogeneity in the magnitude of rapid diastolic filling was measured as the regional variation in percent contribution of atrial systole to end-diastolic volume. Compared with 28 normal subjects, the patients with hypertrophic cardiomyopathy had greater regional variation in both timing (35 ± 24 versus 12 ± 6 ms, p <0.001) and magnitude (10 ± 6 versus 7 ± 4%, p <0.02) of rapid filling. Verapamil reduced the regional variation in timing (to 21 ± 16 ms, p <0.001) and magnitude (to 7 ± 3%, p <0.001) of rapid filling. These regional changes, indicating more uniform regional diastolic performance after verapamil, were associated with improved global diastolic filling: global rapid filling increased in both rate and magnitude and time to peak filling rate decreased. These findings indicate that the beneficial effect of verapamil on left ventricular diastolic function in hypertrophic cardiomyopathy may be mediated by reduction in regional asynchrony.

Original languageEnglish
Pages (from-to)1108-1116
Number of pages9
JournalJournal of the American College of Cardiology
Volume9
Issue number5
Publication statusPublished - 1987

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Hypertrophic Cardiomyopathy
Verapamil
Left Ventricular Function
Radionuclide Angiography
Systole
Therapeutics

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Bonow, R. O., Vitale, D. F., Maron, B. J., Bacharach, S. L., Frederick, T. M., & Green, M. V. (1987). Regional left ventricular asynchrony and impaired global left ventricular filling in hypertrophic cardiomyopathy: Effect of verapamil. Journal of the American College of Cardiology, 9(5), 1108-1116.

Regional left ventricular asynchrony and impaired global left ventricular filling in hypertrophic cardiomyopathy : Effect of verapamil. / Bonow, R. O.; Vitale, D. F.; Maron, B. J.; Bacharach, S. L.; Frederick, T. M.; Green, M. V.

In: Journal of the American College of Cardiology, Vol. 9, No. 5, 1987, p. 1108-1116.

Research output: Contribution to journalArticle

Bonow, R. O. ; Vitale, D. F. ; Maron, B. J. ; Bacharach, S. L. ; Frederick, T. M. ; Green, M. V. / Regional left ventricular asynchrony and impaired global left ventricular filling in hypertrophic cardiomyopathy : Effect of verapamil. In: Journal of the American College of Cardiology. 1987 ; Vol. 9, No. 5. pp. 1108-1116.
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