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Long-term effect of verapamil in hypertrophic cardiomyopathy
Insights
Oral verapamil improved symptoms in patients with hypertrophic cardiomyopathy. Echocardiography revealed reduced left ventricular contractility and hypertrophy, though some patients deteriorated after one year.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertrophic cardiomyopathy is a complex cardiac condition.
- Long-term treatment options require further investigation.
Purpose of the Study:
- To assess the long-term efficacy and safety of oral verapamil in hypertrophic cardiomyopathy patients.
- To evaluate verapamil's impact on cardiac structure and function.
Main Methods:
- A study involving 10 patients with hypertrophic cardiomyopathy.
- Administration of oral verapamil at dosages ranging from 240-720 mg daily.
- Assessment included symptomatic evaluation, electrocardiography, and quantitative echocardiography.
Main Results:
- All patients experienced symptomatic improvement in chest pain or shortness of breath.
- Quantitative echocardiography showed significant reductions in left ventricular contractility, septal hypertrophy, and left ventricular free wall thickening (P < 0.05).
- Improvements in left ventricular compliance were observed, indicated by an increased mitral valve EF slope and decreased left atrial diameter. However, 4 patients deteriorated after one year, and 3 experienced side effects.
Conclusions:
- Oral verapamil demonstrates potential for symptomatic and echocardiographic improvement in hypertrophic cardiomyopathy.
- Long-term use requires careful monitoring due to potential deterioration and side effects.
Abstract:
We studied the long-term effects of oral verapamil (240-720 mg) daily on 10 patients with hypertrophic cardiomyopathy. Symptomatic improvement of chest pain or shortness of breath occurred in all the patients although 4 deteriorated after 1 year. Side effects occurred in 3 patients. The electrocardiogram improved in 4 subjects. Quantitative echocardiography showed a significant (P less than 0.05) decrease in left ventricular contractility (% delta S decreased from 44 +/- 9 to 38 +/- 9, mean +/- SD), septal hypertrophy (1.6 +/- 0.5 to 1.4 +/- 0.5 cm) and % thickening of the left ventricular free wall (79 +/- 29 to 57 +/- 22). There was also moderate evidence of improvement in left ventricular compliance; mitral valve EF slope increased from 38 to 55 mm/sec and left atrial diameter decreased.