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European Heart Journal 1981 2(4):297-305;
Copyright © 1981 by the European Society of Cardiology.
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© 1981, by The European Society Of Cardiology

Hemodynamic effects of strophanthin and pindolol in patients with hypertrophic cardimyopathy

L. STORSTEIN, A. M. ABRAHAMSEN and O. STORSTEIN

Medical Department B. Rikshospitalet, University Clinic Oslo, Norway

Received 5 December 1980; revised 6 February 1981; .

Abstract

The acute hemodynamic effect of 0.5 mg strophanthin and the subsequent effect of 1.O mg pindolol was studied in seven patients with symptomatic hypertrophic cardiomyopathy. Three women and four men, average age 39.1 years (range 15–61), underwent right and left heart catheterization with simultaneous pressure recordings in the left ventricle and the aorta. Strophanthin caused a slight increase in cardiac index, and increases in heart rate, in dp/dt and peak gradient. The Starling curve was shifted upward to the left in five of seven patients. Pindolol had essentially the opposite effects. Neither drug influenced systolic aortic flow. Pindolol led to a significant reduction in the mixed venous oxygen saturation and an increase in arteriovenous oxygen difference.

We conclude that strophanthin had no deleterious effect in the present study and that it may be of benefit in the individual patient by increasing the atrial contribution to ventricular filling and by improving the contractility of the septum and the left ventricular wall in advanced stages of the disease. Further controlled studies are necessary to define the effect of drug treatment in hypertrophic cardiomyopathy.

Key Words: Hypertrophic cardiomyopathy • digitalis • ß-blockade • strophanthin • pindolol


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