Evaluation Of The Effect Of Diltiazem On Cardiac Function

Objective:By applying echocardiogram, measuring Brain Natriuretic Peptide (BNP) andcardiac function classification (NYHA), the effect of i.v administration of diltiazem oncardiac systolic and diastolic function in the patients with organic heart disease wasinvestigated.Methods:Totally40patients admitted in Tai’an municipal central hospitals were studied.Among them,10of them were diagnosed with coronary heart disease,20of them withhypertension, and another10of them with dilated cardiomyopathy and artrialfibrillation. With continuous application of other drugs (except β receptorblockers),heart rate,blood pressure,left ventricle ejection fraction(LVEF),blood BNP aswell as clinical cardiac function classification were measured before and after diltiazemwere applied. Echocardiogram and BNP were examined before drug application, andthen diltiazem was administered i.v. starting with the dose of1ug/kg. During this period,if no side effects (such as blood pressure drop down, dyspnea) were observed, the dosewould be increased with1ug/kg every10min until the largest dose of5ug/kg wasreached. During the whole period, the blood pressure was monitored, and the doseswere adjusted accordingly. The echocardiogram and BNP were measured again24h later.the cardiac function,the clinical symptoms among the three groups were analyzed andcompared before and after drug application.Results:1.Coronary heart disease group: No obvious changes were observed in thickness and inside diameter of left ventricle. Although LVEF was ameliorated, no statistic significant difference was discerned (P>0.05). The reduction of BNP implied the amelioration of left ventricle.2. hypertension group: No statistic significant difference was discerned inthickness and inside diameter of left ventricle. However, the reduction of mitral peak E wave deceleration time (DT) was significant different with p<0.05, implying the improvement of diastolic function in left ventricle.3.Dilated cardiomyopathic group: Noobvious changes were observed in thickness and inside diameter of left ventricle afterdrug application. Although LVEF showed a trend of improvement, no statisticaldifference was discerned (P>0.05). The elongation of DT implied that the diastolicfunction of left ventricle was improved from restrictive filling to the reduction of theleft ventricular diastolic function. The reduce of BNP indicated the improvement of leftventricle function.Conclusion:I.v. administration of diltiazem has no obvious bad effect on the cardiac function ofthe patients with coronary disease, hypertension as well as those with dilatedcardiomyopathy combined with artrial fibrillation.