Effect of Diltiazem on Coronary Hemodynamics and Its Clinical Significance

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概要

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• A small electromagnetic flowprobe was chronically implanted in circumflex branch of left coronary artery of mongrel dogs. Diltiazem, 100μg/Kg, was injected in a basilic vein of the unanesthetized dogs. The changes in phasic coronary flow as well as hemodynamics including aortic pressure (AP), heart rate (HR), and myocardial oxygen extraction ratio (OER) were in estigated. The increasing rates of total coronary flow (TCF) 5, 10, and 20min after the injection of the drug were 90%, 65%, and 40% respectively, Total coronary vascular resistence (TCVR) was inversly proportional to TCF, resulting in a significant decrease after injection. Five min after the drug administration, OER markedly decreased to the level of -45% of control value. The changes in aortic pressure (AP) and heart rate (HR) were unremarkable.In clinical investigation, coronary atrery narrowings (spasms) observed by cine coronary arteriography in a patient with a variant form of angina pectoris were completely dilated after intravenous injection of Diltiazem.In conclusion, Diltiazem exerted a powerful and long-acting vasodilator action on coronary vasculature. Although AP and HR showed unremarkable changes after the injection of the drug, OER decreased significantly. Results obtained suggest that Diltiazem can reduce myocardial oxyge consumption and OER and that the decrease in OER is attributed to not only the peripheral hemodynamic effect of the drug but also probable consequence of the direct action on the myocardium.

• International Heart Journal刊行会の論文

著者

• Abe Hiroyuki

  Department Of Applied Chemistry Faculty Of Engineering The University Of Tokyo

• Yabe Yoshimasa

  1st. Dep. Of Surgery School Of Med. Toho University. Cardiovascular Diagnostic Center School Of Med.

• Yabe Yoshimasa

  Department Of Cardiovascular Research Center Hospital Of Toho University School Of Medicine

• Kawasaki Takeshi

  Department Of Chemistry Faculty Of Science Toho University

• Yabe Yoshimasa

  The 1st Dept. Of Intern. Med. The Jikei Univ. School Of Med.

• Arai Chikao

  Depart. Of Clinical Functional Physiology Faculty Of Medicine Toho Univ.

• Yoshimura Shozo

  Department Of Internal Medicine The Jikei University School Of Medicine

• Kashiwakura Yoshihiro

  Department of Cardiology, Urawa City Hospital.

• Hasegawa Motoharu

  Depart. Of Clinical Functional Physiology Faculty Of Medicine Toho Univ.

• Yamanaka Yoshitada

  Department Of Cardiology Juntendo University School Of Medicine And Department Of Laboratory Medicin

• Yabe Yoshimasa

  1st Dept. Of Intern. Med. Jikei Univ. School Of Med.

• TSUZUKU Akiji

  Department of Central Clinical Laboratory, Toho University School of Medicine

• ABE Masatake

  Department of Central Clinical Laboratory, Toho University School of Medicine

• Yabe Yoshimasa

  Department Of Cardiology Juntendo University School Of Medicine And Department Of Laboratory Medicin

• Kawasaki Takeshi

  Department Of Applied Electronics Tokyo Science University

• Kashiwakura Yoshihiro

  Department Of Cardiology Urawa City Hospital.

• YABE Yoshimasa

  Department of Central Clinical Laboratory, Toho University School of Medicine

• YOSHIMURA Shozo

  Department of Central Clinical Laboratory, Toho University School of Medicine

• HASEGAWA Motoharu

  Department of Central Clinical Laboratory, Toho University School of Medicine

• KASHIWAKURA Yoshihiro

  Department of Central Clinical Laboratory, Toho University School of Medicine

• ARAI Chikao

  Department of Central Clinical Laboratory, Toho University School of Medicine

• ABE Hiroyuki

  Department of Central Clinical Laboratory, Toho University School of Medicine

• KAWASAKI TAKESHI

  Department of Applied Chemistry, Waseda University

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