Cibenzoline attenuates coronary systolic reversal flow in a patient with hypertrophic obstructive cardiomyopathy: a case report

Effects of cibenzoline on coronary hemodynamics, especially systolic reversal flow, were assessed in a 53-year-old man with hypertrophic obstructive cardiomyopathy by coronary flow study using a Doppler guidewire. Intravenous administration of cibenzoline resulted in decreases in the pressure gradient (60 to 0mmHg) and systolic left ventricular pressure (162 to 126 mmHg), and an increase in systolic arterial pressure (102 to 132mmHg). Furthermore, the systolic reversal flow observed at baseline was markedly diminished following administration of cibenzoline. Therefore, we speculate that cibenzoline reduces ventricular wall stress by diminishing the left ventricular obstruction that occurs with compression of the intramyocardial arteries. Cibenzoline-induced attenuation of coronary systolic reversal flow may be associated with the effectiveness of cibenzoline for diminishing the left ventricular obstruction.