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  • Title: [Effects of diltiazem on rest and stress hemodynamics in coronary disease].
    Author: Biamino G, Oeff M, Schröder R.
    Journal: Z Kardiol; 1984 Aug; 73(8):504-9. PubMed ID: 6495810.
    Abstract:
    The acute hemodynamic effects of the Ca-antagonist Diltiazem were measured in the course of diagnostic cardiac catheter examinations in 10 patients with coronary heart disease. After initial step-wise ergometric stress, Diltiazem (D) was applied intravenously for 5 min at a dose of 0.3 mg/kg. The effects on right and left ventricular performance as well as on arterial pressure and heart rate were registered 1, 3, 5, 10 and 15 min after termination of the infusion. Then, a second period of ergometric exertion under identical stress conditions was performed. The results under resting conditions show that D effects a significant increase in left ventricular filling pressure (p greater than 0.005), which, however, only lasts a few minutes. After D, the systolic and mean arterial pressure decreases significantly (p greater than 0.001); there is no reflex-induced increase in the heart rate, which on the contrary is significantly lower (p greater than 0.005) 15 min after termination of the infusion than the initial value. The stroke volume index increases from 40 to maximally 48 ml/m2 after D. Comparison of the hemodynamic parameters under ergometric stress before and 20 min after D shows that, on termination of stress, the filling pressure of the left ventricle is reduced. This behavior can largely be attributed to the reduction of the systolic pressure after D (maximal value before D 181, after D 167 mm Hg). Also, the stress-induced increase in the heart rate takes a flatter course after D than before it. The results obtained thus provide evidence that, at a dosage of 0.3 mg/kg, D has no significant negative inotropic effect and probably leads to a decrease of the myocardial oxygen consumption reducing the systolic pressure and, to a lesser degree, heart rate.
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