Effect of verapamil on left ventricular function: A randomized,placebo-controlled study |
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Authors: | Ronald E. Vlietstra Maria A.C. Farias Robert L. Frye Hugh C. Smith Erik L. Ritman |
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Affiliation: | From the Division of Cardiovascular Diseases and Internal Medicine and the Department of Physiology and Biophysics, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA |
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Abstract: | Verapamil has a negative inotropic action in isolated cardiac muscle. Its effects on left ventricular function were tested in 25 patients with suspected coronary artery disease. A double-blind, randomized, placebo-controlled study design was used. Verapamil (0.2 mg/kg over 10 minutes) significantly lowered mean arterial pressure (from 105 to 89 mm Hg) while increasing the cardiac index (from 2.8 to 3.1 liters/min/m2). No statistically significant effect was seen on heart rate, left ventricular end-diastolic pressure or end-systolic volume index, ejection fraction, peak rates of systolic wall thickening or diastolic wall thinning, or percentage of hemiaxial shortening. However, there was a small increase in the left ventricular end-diastolic volume index (from 94 to 102 ml/m2). Important findings were a reduction in systemic vascular resistance (from 39 to 30 U·m2), an increase in left ventricular end-diastolic volume index consistent with a negative inotropic effect, and no evidence of improved regional wall dynamics in portions of the left ventricular wall considered hypokinetic because of myocardial ischemia. |
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Keywords: | Address for reprints: Ronald E. Vlietstra MB ChB Division of Cardiovascular Diseases and Internal Medicine Mayo Clinic Rochester Minnesota 55905. |
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