Disopyramide in hypertrophic cardiomyopathy II. Noninvasive assessment after oral administration

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Abstract

The effects of oral disopyramide 150 mg 4 times a day were compared with propranolol 40 mg 4 times a day and placebo in 10 patients with hypertrophic cardiomyopathy and resting obstruction (7 patients) or latent obstruction (3 patients), in a randomized double-blind crossover design; each drug was given for a period of 4 days. As determined from echocardiographic evaluation of systolic anterior motion of the mitral valve, the subaortic pressure gradient was decreased from 61 ± 20 mm Hg with placebo to 5 ± 15 mm Hg with disopyramide (p < 0.01), and 30 ± 30 mm Hg with propranolol (p < 0.01). Disopyramide was more effective than propranolol (p < 0.01). Disopyramide and propranolol both shortened left ventricular ejection time from 352 ± 51 ms with placebo to 314 ± 26 an 322 ±41 ms, respectively (p < 0.01). Preejection period was lengthened from 93 ± 35 ms with placebo to 119 ± 25 ms with disopyramide, but was unchanged by propranolol at 98 ± 23 ms. Disopyramide increased exercise duration versus placebo (10.4 ± 2 vs 9.6 ± 2 minutes, respectively (p < 0.05), whereas propranolol produced no significant change (8.8 ± 2 minutes).

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This study was supported by grants from the Canadian Heart Foundation and the Heart and Stroke Foundation of Ontario, Canada.

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