[Therapy of latent cardiomyopathy with verapamil]

In an open, randomized cross-over trial lasting two months, 21 patients with latent cardiomyopathy were either untreated or received verapamil 120 mg three times daily. Angina and dyspnea improved in 14 of the 21 patients. These symptoms worsened in one, remained unchanged in six (P less than 0.05). During exercise the pulmonary artery diastolic pressure fell from a mean of 25.3 +/- 7.6 to 20.1 +/- 6.6 mm Hg (P less than 0.05); (at rest, from mean of 10.7 +/- 5.2 to 9.0 +/- 4.5 mm Hg - not significant). In nine patients with a raised resting PA diastolic pressure verapamil produced a significant reduction (from 15.4 +/- 2.7 to 11.1 +/- 4.1 mm Hg) (P less than 0.05). All other hemodynamic parameters remained unchanged. These clinically and hemodynamically favorable effects are possibly due to improved diastolic ventricular function by verapamil. In latent cardiomyopathy any impairment of diastolic relaxation may be more important pathogenetically than reduction in systolic ventricular function.