caa a22 4500 475833422 CHVBK 20180406123847.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1023/A:1007823116491 doi (NATIONALLICENCE)springer-10.1023/A:1007823116491 Dose-Dependent Effects of Intracoronary Verapamil on Systemic and Coronary Hemodynamics [Elektronische Daten] [Olaf Oldenburg, Holger Eggebrecht, Jörg Herrmann, Christoph Naber, Michael Haude, Raimund Erbel, Dietrich Baumgart] Calcium antagonists are used in interventional cardiology to prevent coronary vasoconstriction or to overcome the no-reflow phenomenon. The aim of the current study was to evaluate the dose-dependent effects of intracoronary verapamil on systemic and coronary hemodynamics. In 20 patients scheduled for routine coronary angiography, heart rate, blood pressure, and ECG recordings were recorded continuously and intracoronary flow velocity was obtained by intracoronary Doppler measurements in angiographically normal vessels. The cross-sectional area, measured by quantitative coronary angiography, allowed the calculation of coronary blood flow (CBF) and the coronary vascular resistance index (CVRI). Without premedication, increasing dosages of verapamil (0.01 mg, 0.1 mg, 1.0 mg, and 2.0 mg) were injected into the left coronary artery. Intracoronary verapamil administration led to a decrease in systemic blood pressure only after administration of 1.0 mg or 2.0 mg (change in mean arterial pressure: from 87.6 ± 14.6 mmHg to 80.1 ± 14.9 mmHg and 78.5 ± 13.9 mmHg, respectively; both P < 0.05) without a change in heart rate. Epicardial diameters of the left coronary artery increased only at dosages of 1.0 mg and 2.0 mg (from 2.14 ± 0.4 mm to 2.22 ± 0.3 mm, P < 0.01), whereas the coronary blood flow velocity increased significantly at the smallest dosage of 0.01 mg (from 19.9 ± 8.7 cm/s to 33.2 ± 14.9 cm/s, P < 0.001) and was further enhanced with increasing dosages. CBF increased and CVRI decreased at every dosage of verapamil compared with baseline values. CBF increased also after 0.1 mg (from 13.5 ± 6.5 mL/min to 19.5 ± 9.3 mL/min; P < 0.05), reaching a maximal effect after administration of 1.0 mg verapamil (26.3 ± 16.1 mL/min, P < 0.05). Application of 2.0 mg did not further increase CBF compared with 1.0 mg. Intracoronary application of verapamil leads to a decrease in systemic blood pressure at higher dosages, whereas heart rate remains unchanged at any dosage. The maximal increase in coronary blood flow and decrease in vascular resistance can be reached by administration of 1.0 mg verapamil into the left coronary artery. Kluwer Academic Publishers, 2000 calcium antagonists nationallicence verapamil nationallicence hemodymanic effects nationallicence blood pressure nationallicence heart rate nationallicence coronary blood flow nationallicence coronary vascular resistance nationallicence Oldenburg Olaf Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Eggebrecht Holger Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Herrmann Jörg Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Naber Christoph Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Haude Michael Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Erbel Raimund Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Baumgart Dietrich Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/6(2000-12-01), 651-655 0920-3206 14:6<651 2000 14 10557 https://doi.org/10.1023/A:1007823116491 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1007823116491 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Oldenburg Olaf Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Eggebrecht Holger Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Herrmann Jörg Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Naber Christoph Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Haude Michael Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Erbel Raimund Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 700 1- Baumgart Dietrich Department of Cardiology, Division of Internal Medicine, University of Essen, Germany aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 14/6(2000-12-01), 651-655 0920-3206 14:6<651 2000 14 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer