Impact of Chronic Cibenzoline Therapy on Left Ventricular Remodeling in Patients With Hypertrophic Non-Obstructive
Mareomi Hamada1, Akiyoshi Ogimoto1, Takashi Otani2
1Division of Cardiology, Uwajima City Hospital.
Insights
Chronic cibenzoline therapy (CCT) in hypertrophic non-obstructive cardiomyopathy (HNCM) patients preserved left ventricular (LV) systolic function and reduced hypertrophy. Longer CCT durations showed greater improvements in LV remodeling and diastolic function.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Hypertrophic non-obstructive cardiomyopathy (HNCM) presents unique challenges in understanding left ventricular (LV) remodeling.
- The impact of long-term therapy duration on LV remodeling in HNCM remains poorly defined.
Purpose of the Study:
- To investigate the effects of chronic cibenzoline therapy (CCT) duration on LV remodeling in HNCM patients.
- To assess the relationship between CCT duration and changes in echocardiographic and electrocardiographic parameters.
Main Methods:
- A cohort of 254 HNCM patients was divided into three groups based on CCT duration (≥10 years, 5-10 years, 1-5 years).
- Electrocardiograms (ECG) and echocardiograms, including LV long distance (LVLD), were analyzed before and after CCT.
- Changes in ECG indices, LV wall thickness, dimensions, fractional shortening, left atrial dimension, E/A ratio, and E/early diastolic annular velocity (Ea) ratio were compared across groups.
Main Results:
- CCT led to decreased LV wall thickness and improved ECG indices in all patient groups.
- LV dimensions and fractional shortening were preserved across all CCT durations.
- LV long distance (LVLD) significantly increased in all groups post-therapy, with greater improvements observed in patients with longer CCT durations (≥10 years).
- The E/Ea ratio improved in patients with longer CCT durations (≥10 years and 5-10 years).
Conclusions:
- Chronic cibenzoline therapy effectively preserves LV systolic function and reduces LV hypertrophy in HNCM patients.
- Longer durations of CCT are associated with more significant improvements in LV remodeling and diastolic function (E/Ea ratio).
- CCT demonstrates therapeutic benefits for patients with HNCM, particularly with extended treatment periods.
Background:
Changes in left ventricular (LV) remodeling, especially in relation to the duration of therapy, are poorly understood in patients with hypertrophic non-obstructive cardiomyopathy (HNCM).
Methods And Results:
This study included 254 consecutive patients with HNCM. Patients were divided into 3 groups according to the length of chronic cibenzoline therapy (CCT): Group I (n=104), CCT ≥10 years; Group II (n=85), 5 years≤CCT<10 years; and Group III (n=65), 1 year ≤CCT<5 years. SV1+RV5 and the maximum depth of precordial negative T waves were measured on electrocardiograms (ECG). In addition to routine echocardiographic indices, we measured the distance between the mitral valve and the apex (i.e., the "LV long distance" [LVLD]). After CCT, ECG indices and LV wall thicknesses were decreased in all 3 groups. LV dimensions and LV fractional shortening were preserved, and did not differ significantly among the groups. Left atrial dimension and the E/A ratio also did not differ among the groups, whereas the E/early diastolic annular velocity (Ea) ratio was decreased in Groups I and II. After CCT, LVLD was increased in all groups (all P<0.0001). These improvements were greater in Group I than in Groups II and III.
Conclusions:
CCT preserved LV systolic function and reduced LV hypertrophy in patients with HNCM. The E/Ea ratio was improved in Groups I and II. Thus, CCT aids in treating patients with HNCM.
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