Abstract
There has been recent interest in attempting to use the arterial vasodilating activity of calcium channel blocking drugs to decrease left ventricular (LV) afterload in patients with severe heart failure (CHF). However, unlike other vasodilators used in the treatment of CHF, calcium channel blocking drugs possess intrinsic negative inotropic activity as well; clinical studies have shown that both verapamil [1] and nifedipine [2,3] may lead to marked clinical deterioration in patients with severe CHF. Diltiazem, the third presently available calcium channel blocking agent, has less intrinsic negative inotropic effect than verapamil and nifedipine [4,5] and has been shown in one study to be acutely beneficial in patients with severe CHF [6].
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References
Chew CY, Hecht HS, Collett JT, McAllister RG, Singh BN (1981) Influence of severity of ventricular dysfunction on hemodynamic responses to intravenously administered verapamil in ischemic heart disease. Am J Cardiol 47: 917–922
Elkayam U, Weber L, McKay CR, Rahimtoola SH (1985) Spectrum of acute hemodynamic effects of nifedipine in severe congestive heart failure. Am J Cardiol 56: 560–566
Brooks N, Cattell M, Pidgeon J, Balcon R (1980) Unpredictable response to nifedipine in severe cardiac failure. Br Med J 281: 1324
Henry PD(1980) Comparative pharmacology ofcalcium antagonists: nifedipinc. verapamil. and diltiazem. Am J Cardiol 46:1047–1058
Stone PH, Antman EM, Muller JE, Braunwald E (1980) Calcium channel blocking agents in the treatment of cardiovascular disorders. II. Hemodynamic effects and clinical applications. Ann Intern Med 93: 886–904
Walsh RA, Porter CB, Starling MR, O’Rourke RA (1984) Beneficial hemodynamic effects of intravenous and oral diltiazem in severe congestive heart failure. J Am Coll Cardiol 3: 1044–1050
Packer M, Lee WH, Medina N, Yushak M (1985) Comparative negative inotropic effects of nifedipine and diltiazem in patients with severe left ventricular dysfunction (abstract). Circulation 72: III - 275
Elkayam U, Weber L, Torkan B, McKay CR, Rahimtoola SH (1984) Comparison of hemodynamic responses to nifedipine and nitroprusside in severe chronic congestive heart failure. Am J Cardiol 53: 1321–1325
Elkayam U, Weber L, McKay CR, Rahimtoola SH (1984) Differences in hemodynamic response to vasodilation due to calcium channel antagonism with nifedipine and direct-acting agonism with hydralazine in chronic refractory congestive heart failure. Am J Cardiol 54: 126–131
Leithe ME, Margorien RD, Hermiller JB, Unverferth DV, Leier CV (1984) Relationship between central hemodynamics and regional blood flow in normal subjects and in patients with congestive heart failure. Circulation 69: 57–64
Cogan JJ, Humphreys MH, Carlson CJ, Rapaport E (1980) Renal effects of nitroprusside and hydralazine in patients with congestive heart failure. Circulation 61: 316–323
Creager MA, Halperin JL, Bernard DB, Faxon DP, Melidossian CD, Gavras H, Ryan TJ (1981) Acute regional circulatory and renal hemodynamic effects of converting-enzyme inhibition in patients with congestive heart failure. Circulation 64: 483–489
Elkayam U, Weber L, Campese VM, Massry SG, Rahimtoola SH (1984) Renal hemodynamic effects of vasodilation with nifedipine and hydralazine in patients with heart failure. J Am Coll Cardiol 4: 1261–1267
Cohn JN, Levine TB, Francis GS, Goldsmith S (1981) Neurohumoral control mechanisms in congestive heart failure. Am Heart J 102: 509–514
Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311: 819–823
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© 1991 Springer-Verlag Berlin Heidelberg
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Kulick, D.L., Elkayam, U. (1991). Central and Renal Hemodynamic Effects of Diltiazem in Chronic Heart Failure. In: Lewis, B.S., Kimchi, A. (eds) Heart Failure Mechanisms and Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58231-8_32
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DOI: https://doi.org/10.1007/978-3-642-58231-8_32
Publisher Name: Springer, Berlin, Heidelberg
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