[Pharmacological effects on left diastolic ventricular function in acute myocardial infarct: comparison of gallopamil and atenolol]

Abstract

The aim of the study was to assess the effects of gallopamil and atenolol administration on left ventricular (LV) relaxation and filling in patients (pts) with acute myocardial infarction (AMI), by pulsed Doppler echocardiography (PDE). Two days after first AMI, 14 pts aged 56 +/- 10 years in Killip class I and treated with thrombolysis were randomized to gallopamil (50 mcg/Kg over 5 min) or atenolol (5 mg over 5 min) IV 10 ml bolus, with a 24 hour time interval, in a cross-over double blind sequence. Four PDE were performed in each patient: at baseline, before gallopamil and atenolol IV bolus, and a 15 min after each bolus. The following Doppler parameters were calculated: early (E) and late (A) peak filling velocities and their ratios (E/A), early (Ei), late (Ai) and total (TVi) diastolic filling time velocity integrals; the ratio between Ei and Ai (Ei/Ai), the peak filling rate normalized to mitral stroke volume (calculated as E/TVi [nPRP]), the percentage of atrial contribution to total diastolic filling (%AC), and the isovolumic relaxation time (nTRIV) normalized to an 800msec RR cycle length. Compared to baseline PDE evaluation, gallopamil administration significantly shortened nTRIV (89 +/- 13 vs 116 +/- 13 msec), improved early LV filling parameters (E: 74.5 +/- 14.0 vs 58.1 +/- 14.6 cm/sec; E/A 1.2 +/- 0.4 vs 0.9 +/- 0.3; Ei: 11.2 +/- 1.8 vs 8.9 +/- 2.0 cm; Ei/Ai: 1.8 +/- 0.6 vs 1.3 +/- 0.6; nPRP: 3.9 +/- 1.0 vs 3.5 +/- 1.0 SV/sec), and reduced %AC (35.6 +/- 8.8 vs 44.6 +/- 10.6). A and Ai were not significantly changed.(ABSTRACT TRUNCATED AT 250 WORDS)