Hemodynamic effects of intravenous bepridil in patients with normal left ventricular function

Joseph S Alpert, Joseph R. Benotti, Priscilla M. Brady, Jane E. McCue, Bonnie H. Weiner, Ira S. Ockene

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Calcium-channel blockers are known to have depressant effects on atrioventricular (AV) nodal conduction and myocardial contractility. Because of these known depressant effects, bepridil hydrochloride, a new, long-acting, antianginal and antiarrhythmic calcium-channel blocker, was administered intravenously to patients without heart failure to determine acute hemodynamic effects. The patients studied had normal ventricular function, were without electrocardiographic conduction disturbances and were taking no drug except sublingual nitroglycerin for at least 24 hours before bepridil infusion. The study protocol included right- and left-sided cardiac catheterization with infusion of bepridil at 2 mg/kg for 15 minutes followed by 1 mg/kg for 15 minutes in 10 patients, and infusion of bepridil at 3 mg/kg for 15 minutes followed by 1 mg/kg for 15 minutes in 8 patients. Pressures, Fick cardiac output, resistances, left ventricular (LV) dP dt, LV stroke work index and rate-pressure product of the left ventricle were monitored. There were no significant changes during bepridil infusion at either dose for cardiac output, systemic vascular and pulmonary vascular resistances, LV stroke work index, heart rate, arterial blood pressure and ratepressure product. There was mild depression of LV dP dt during bepridil infusion. Further, LV end-diastolic pressure, pulmonary capillary wedge pressure and pulmonary arterial pressures were significantly increased during bepridil infusion. There were no apparent changes in AV nodal or intraventricular conduction during bepridil infusion. We conclude that bepridil appears to be a safe drug for intravenous administration despite mild depression of myocardial function in patients with normal baseline hemodynamic function who are not receiving concomitant β-blocker therapy.

Original languageEnglish (US)
JournalThe American journal of cardiology
Volume55
Issue number7
DOIs
StatePublished - Mar 15 1985
Externally publishedYes

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Bepridil
Left Ventricular Function
Hemodynamics
Calcium Channel Blockers
Cardiac Output
Arterial Pressure
Stroke
Pressure
Pulmonary Wedge Pressure
Ventricular Function
Nitroglycerin
Cardiac Catheterization
Pharmaceutical Preparations
Intravenous Administration
Vascular Resistance
Heart Ventricles
Blood Vessels
Heart Failure
Heart Rate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hemodynamic effects of intravenous bepridil in patients with normal left ventricular function. / Alpert, Joseph S; Benotti, Joseph R.; Brady, Priscilla M.; McCue, Jane E.; Weiner, Bonnie H.; Ockene, Ira S.

In: The American journal of cardiology, Vol. 55, No. 7, 15.03.1985.

Research output: Contribution to journalArticle

Alpert, Joseph S ; Benotti, Joseph R. ; Brady, Priscilla M. ; McCue, Jane E. ; Weiner, Bonnie H. ; Ockene, Ira S. / Hemodynamic effects of intravenous bepridil in patients with normal left ventricular function. In: The American journal of cardiology. 1985 ; Vol. 55, No. 7.
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abstract = "Calcium-channel blockers are known to have depressant effects on atrioventricular (AV) nodal conduction and myocardial contractility. Because of these known depressant effects, bepridil hydrochloride, a new, long-acting, antianginal and antiarrhythmic calcium-channel blocker, was administered intravenously to patients without heart failure to determine acute hemodynamic effects. The patients studied had normal ventricular function, were without electrocardiographic conduction disturbances and were taking no drug except sublingual nitroglycerin for at least 24 hours before bepridil infusion. The study protocol included right- and left-sided cardiac catheterization with infusion of bepridil at 2 mg/kg for 15 minutes followed by 1 mg/kg for 15 minutes in 10 patients, and infusion of bepridil at 3 mg/kg for 15 minutes followed by 1 mg/kg for 15 minutes in 8 patients. Pressures, Fick cardiac output, resistances, left ventricular (LV) dP dt, LV stroke work index and rate-pressure product of the left ventricle were monitored. There were no significant changes during bepridil infusion at either dose for cardiac output, systemic vascular and pulmonary vascular resistances, LV stroke work index, heart rate, arterial blood pressure and ratepressure product. There was mild depression of LV dP dt during bepridil infusion. Further, LV end-diastolic pressure, pulmonary capillary wedge pressure and pulmonary arterial pressures were significantly increased during bepridil infusion. There were no apparent changes in AV nodal or intraventricular conduction during bepridil infusion. We conclude that bepridil appears to be a safe drug for intravenous administration despite mild depression of myocardial function in patients with normal baseline hemodynamic function who are not receiving concomitant β-blocker therapy.",
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