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      Effect of Propranolol and Disopyramide on Left Ventricular Function at Rest and during Exercise in Hypertrophic Cardiomyopathy


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          In 19 patients with hypertrophic cardiomyopathy (15 males, 4 females, mean age 49.2 ± 10.8 years) left ventricular function was studied with radionuclide ventriculography at rest and during exercise in a crossover design without intervention and after disopyramide and propranolol treatment. 15 of the 19 patients had a resting or latent intraventricular gradient of more than 30 mm Hg. Left ventricular function at rest and during exercise was evaluated before medication, 90 min after oral administration of 200 mg disopyramide or 160 mg propranolol and after 3 weeks of oral therapy with disopyramide 200 mg 2 times a day or propranolol 80 mg 4 times a day. After long-term treatment with disopyramide, resting ejection fraction decreased from 72 ± 12 to 69 ± 14% (p < 0.01) and peak ejection rate (PER) decreased from 3.46 ± 135 to 3.24 ± 65 end-diastolic volume (EDV)·s-<sup>1</sup> (p < 0.01). Peak filling rate (PFR) at rest decreased from 3.01 ± 0.8 to 2.77 ± 0.63 EDV·S”<sup>1</sup> (p < 0.05). Time to peak filling rate (TPFR) at rest and during exercise after acute and chronic therapy did not change compared to control values. Acute and long-term administration of propranolol lead to a significant reduction in heart rate at rest and during exercise. During exercise, PFR was significantly reduced: from 5.76 ± 1.32 (at baseline) to 4.27 ± 1.0 (acute therapy; p < 0.01) and 4.34 ± 0.97 EDV·s-<sup>1</sup> (chronic therapy); TPFR was significantly prolonged: from 122 ± 32 (at baseline) to 144 ± 22 (acute therapy) and 149 ± 39 ms (chronic therapy, p < 0.01) and PFR/PER was significantly lower after acute and long-term therapy with propranolol. The data indicate that disopyramide has a slight negative inotropic activity on systolic ventricular function. Diastolic filling is also impaired. Propranolol reveals a strong negative chronotropic effect and in addition a negative influence on systolic and diastolic ventricular function.

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          Author and article information

          S. Karger AG
          12 November 2008
          : 80
          : 2
          : 81-88
          aDepartment of Cardiology, Center of Internal Medicine, and bDepartment of Nuclear Medicine, Center of Radiology, Johann Wolfgang Goethe-University, Medical School, Frankfurt, FRG
          174983 Cardiology 1992;80:81–88
          © 1992 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 24 June 1991
          : 10 September 1991
          Page count
          Pages: 8
          General Cardiology

          General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
          Hypertrophic cardiomyopathy,Propranolol,Exercise,Disopyramide,Left ventricular function


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