caa a22 4500 475833317 CHVBK 20180406123846.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1023/A:1007871032421 doi (NATIONALLICENCE)springer-10.1023/A:1007871032421 Comparison of the Effect of Verapamil and Propranolol on Response of Coronary Vasomotion to Cold Pressor Test in Symptomatic Patients with Hypertrophic Cardiomyopathy [Elektronische Daten] [Pawel Dimitrow, Marek Krzanowski, Rafal Nizankowski, Andrzej Szczeklik, Jacek Dubiel] Impaired endothelium-dependent vasodilatation of coronary resistance vessels has been demonstrated in patients with hypertrophic cardiomyopathy (HC). The aim of this study was to compare the effect of verapamil and propranolol on the response of diastolic coronary blood flow velocity (CBFV) and coronary vascular resistance index to the cold pressor test (CPT) in symptomatic HC patients. In 15 patients with HC, the CBFV was measured in the distal portion of the left anterior descending coronary artery using high-sensitivity transthoracic Doppler echocardiography. Peak diastolic CBFV and coronary vascular resistance index (calculated as ratio of mean aortic pressure/CBFV ratio) were measured at baseline and after CPT. Changes of these parameters induced by the CPT (expressed as percentage of baseline values) were compared after verapamil and propranolol treatment in a crossover study. The same measurements were obtained in nine healthy control subjects. CPT induced an increasing pattern of CBFV during verapamil therapy, which was absent in CPT after propranolol administration (10.1 ± 5.6% vs. −0.9 ± 4.1%, P < 0.01). In healthy controls CBFV increased in response to CPT more than in HC patients receiving verapamil or propranolol (23.1±12.8% P < 0.01 and P < 0.05, respectively). The coronary vascular resistance index increased during the CPT significantly less on verapamil than on propranolol treatment (3.5 ± 9.2% vs. 18.1 ± 13.5%, P < 0.01). In healthy controls the coronary vascular resistance index decreased during CPT −4.5 ± 8.5% (P < 0.05 vs. verapamil and P < 0.01 vs. propranolol). Verapamil improved the coronary vasomotor response to CPT in relation to propranolol. Verapamil blunted the increase of the coronary vascular resistance index to the CPT in comparison with its change at CPT after propranolol. Thus, coronary endothelial dysfunction in symptomatic HC patients may be partially reduced by verapamil in comparison with propranolol treatment. Kluwer Academic Publishers, 2000 hypertrophic cardiomyopathy nationallicence verapamil nationallicence propranolol nationallicence endothelium-dependent vasodilatation nationallicence Dimitrow Pawel 2nd Department of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland aut Krzanowski Marek Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut Nizankowski Rafal Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut Szczeklik Andrzej Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut Dubiel Jacek 2nd Department of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/6(2000-12-01), 643-650 0920-3206 14:6<643 2000 14 10557 https://doi.org/10.1023/A:1007871032421 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007871032421 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dimitrow Pawel 2nd Department of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland aut NATIONALLICENCE 700 1- Krzanowski Marek Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut NATIONALLICENCE 700 1- Nizankowski Rafal Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut NATIONALLICENCE 700 1- Szczeklik Andrzej Department of Medicine, Jagiellonian University School of Medicine, Krakow, Poland aut NATIONALLICENCE 700 1- Dubiel Jacek 2nd Department of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/6(2000-12-01), 643-650 0920-3206 14:6<643 2000 14 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer