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Regional coronary hemodynamic effects of diltiazem in man
- Publication Year :
- 1988
-
Abstract
- We evaluated the changes in regional coronary hemodynamics induced by diltiazem, 0.25 mg/kg intravenously, in nine patients with 75% to 90% diameter stenosis of the left anterior descending coronary artery (LAD) (group 1) and in 10 patients with 100% occlusion of the LAD and collaterals to the distal LAD (group 2). Although diltiazem induced similar changes in systemic hemodynamics in the two groups, a decrease in anterior coronary vascular resistance (ACVR) and an increase in great cardiac vein flow (GCVF) were observed after administration of diltiazem in all patients in group 1 but in only 6 of 10 patients in group 2 (subgroup 2B). ACVR increased and GCVF decreased after administration of diltiazem in 4 of 10 patients in group 2 (subgroup 2A). Clinico-angiographic characteristics, origin of collaterals, and diltiazem-induced changes in systemic hemodynamics were similar in subgroups 2A and 2B. Thus diltiazem increases coronary flow distal to a stenotic coronary artery but can decrease regional coronary flow and increase regional coronary resistance in a minority of patients with an occluded coronary artery supplied by collaterals, probably through a steal mechanism.
- Subjects :
- Male
medicine.medical_specialty
Coronary Disease
Anterior Descending Coronary Artery
Great cardiac vein
Internal medicine
Coronary Circulation
Occlusion
medicine
Coronary hemodynamics
Humans
Diltiazem
Hemodynamic effects
coronary hemodinamics effect
business.industry
diltiazem
Hemodynamics
Middle Aged
medicine.anatomical_structure
Anesthesia
Injections, Intravenous
cardiovascular system
Cardiology
Vascular resistance
Female
Cardiology and Cardiovascular Medicine
business
regional perfusion
circulatory and respiratory physiology
medicine.drug
Artery
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....5cebdb63cc8ce65b4a306dd8f4656598