Verapamil therapy: a new approach to the pharmacologic treatment of hypertrophic cardiomyopathy. I. Hemodynamic effects.

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Abstract
The hemodynamic effects of intravenous verapamil administration were examined in 27 patients with hypertrophic cardiomyopathy. Increasing doses of verapamil produced small increases in heart rate and cardiac output and a significant decrease in systolic blood pressure, but had no significance effect on mean pulmonary artery wedge pressure or left ventricular end-diastolic pressure. The highest dose of verapamil increased heart rate from 72 +/- 3 to 81 +/- 6 beats/min and reduced systolic blood pressure from 118 +/- 8 to 99 +/- 5 mm Hg (p less than 0.005). This dose decreased the basal left ventricular outflow tract gradient from 94 +/- 14 to 49 +/- 14 mm Hg and the average left ventricular outflow tract gradient during the Valsalva maneuver from 76 +/- 5 to 63 +/- 13 mm Hg, during amyl nitrite inhalation from 69 +/- 15 to 39 +/- 13 mm Hg, and during isoproterenol infusion from 108 +/- 29 to 70 +/- 21 mm Hg (p less than 0.01). These results indicate that verapamil can significantly decrease left ventricula...