Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise
To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), we performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol (160-320 mg/day). LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) < 2.5 end-diastolic volumes (EDV)/sec or time to PFR > 180 msec, was present in 15. During verapamil, resting ejection fraction decreased (control 50 + 10% ( + SD ), verapamil 45 + 12%, p < 0.005), but resting diastolic filling improved: PFR increased (control 1.9 + 0.6 EDV/sec, verapamil 2.3 + 0.9 EDV/sec, p < 0.005) and time to PFR decreased (control 185 + 38 mssec, verapamil 161 + 27 msec, p < 0.05). Exercise ejection fraction did not change during verapamil (control 42 + 13%, verapamil 43 + 12%. NS), but exercise PFR increased (control 3.1 + 0.9 EDV/sec, verapamil 3.6 + 1.1 EDV/sec, p < 0.05) and exercise time to PFR decreased (control 108 + 30 msec, verapamil 91 + 17 msec, p < 0.05). In contrast, propranolol did not alter ejection fraction, PFR, or time to PFR at rest or during exercise. Thus, LV ejection fraction is decreased by verapamil at rest but is unchanged during exercise. While LV systolic function is not improved by verapamil, LV diastolic filling is enhanced by verapamil, both at rest and during exercise. These mechanisms may account in part for the symptomatic improvement in many patients during verapamil therapy.
- Research Organization:
- National Inst. of Health, Bethesda, MD
- OSTI ID:
- 5105324
- Journal Information:
- Circulation; (United States), Vol. 65:7
- Country of Publication:
- United States
- Language:
- English
Similar Records
Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography
Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance
Related Subjects
ANTIHYPERTENSIVE AGENTS
BIOLOGICAL EFFECTS
HEART
BIOMEDICAL RADIOGRAPHY
DYNAMIC FUNCTION STUDIES
RADIOISOTOPE SCANNING
BIOLOGICAL FUNCTIONS
BLOOD FLOW
CARDIOVASCULAR DISEASES
ERYTHROCYTES
EXERCISE
ISOMERIC NUCLEI
PATIENTS
TECHNETIUM 99
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARDIOVASCULAR AGENTS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
FUNCTIONS
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATERIALS
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPES
RADIOLOGY
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics