geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

A double-blind, placebo-controlled crossover trial of nadolol and verapamil in mild and moderately symptomatic hypertrophic cardiomyopathy


, : A double-blind, placebo-controlled crossover trial of nadolol and verapamil in mild and moderately symptomatic hypertrophic cardiomyopathy. Journal Of The American College Of Cardiology. 21(7): 1672-1679

Objectives. The aim of this study was to determine whether therapy with a beta-adrenergic or calcium channel blocking agent can improve the functional capacity and quality of life of patients with mild or moderately symptomatic hypertrophic cardiomyopathy. Background. Both beta-blockers and calcium channel blockers may alleviate symptoms in hypertrophic cardiomyopathy, but previous studies have been performed in hospitalized patients or have been open studies without control subjects. Methods. A randomized, double-blind crossover trial of nadolol, verapamil and placebo, administered for periods of 4 weeks each, was performed in 18 patients with mild or moderately symptomatic hypertrophic cardiomyopathy (10 men, 8 women; mean age +- SD 39 +- 17 years). A detailed symptom assessment, bicycle exercise testing, echocardiography and Holter monitoring were performed in each period. Results. Two patients withdrew from the study owing to symptomatic sinus bradycardia during nadolol therapy. Neither drug improved maximal oxygen consumption (placebo 26 +- 8, verapamil 23 +- 6, nadolol 21 +- 7 ml/kg per min; p = 0.1). Peak exercise work load was reduced by gtoreq 10 W in 13 patients (81%) during nadolol therapy and in 4 patients (25%) during verapamil therapy (p = 0.005, nadolol vs. verapamil). Despite the effects on exercise capacity, 13 patients (81%) preferred drug treatment (8 verapamil, 5 nadolol) over placebo (p = 0.001). Verapamil improved reported performance at work compared with nadolol (p = 0.01) and tended to improve other measures of health-related behavior and symptoms compared with nadolol and placebo. Conclusions. In patients with mild or moderately symptomatic hypertrophic cardiomyopathy, exercise capacity was not improved by nadolol or verapamil, and individuals were more often impaired by nadolol than with verapamil. Nevertheless, many patients derived symptomatic benefit from drug therapy, especially with verapamil.

US$19.90

PMID: 8496536

DOI: 10.1016/0735-1097(93)90386-f


Other references

Idris, B.L.rson, D., 1988: Spatial and seasonal price differences: a case study of sorghum producers in Sudan. Spatial and seasonal price difference for sorghum in the Sudan are investigated. Results indicate that the producer's share of the consumer price is low. Seasonal price spreads indicate an excess return to the storage function. Causes of thes...

Hoskins, B.; Feibelman, R.Y.; Koury, A.M.; Taylor, R., 1979: Effectiveness of insulin therapy on altered renal calcium transport in diabetic rats. The uptake of 45Ca was measured in slices of kidney cortex from normal rats, streptozotocin-diabetic rats, and streptozotocin-diabetic rats treated early and late with insulin. Insulin therapy was performed such that blood glucose levels were cont...

Dange, P.; Sarma, H.; Pandey, B.Narain.; Mishra, K.Prasad., 2008: Radiation-induced incidence of thymic lymphoma in mice and its prevention by antioxidants. Previous reports from our laboratory have shown that in Swiss female mice exposed to an acute dose (3 Gy) of whole body irradiation (WBI), induced thymic lymphoma (TL) resulted after three to four weeks of exposure. The present study was aimed to...

Bunting, E.S.; Willey, L.A., 1959: The cultivation of maize for fodder and ensilage. 2. The effect of changes in plant density. Maize of several varieties, comprising material of early, medium-early, medium-late or late maturity, was grown for 6 yr at 2 locations from May to Oct. in 24-27 in. rows at plant densities varying from 4 to 16 plants/sq. yd. Plant density had lit...

Weber, R.; Hrynczuk, B., 2005: The influence of cultivation technology applied in the reclamation of multi-year fallow on some chemical properties of soil and variability in yielding of plants. The influence of four cultivation modes applied on a fallow in the first year of direct sowing in the succeeding years, on the variability in yield of oats (Avena sativa), winter triticale (Triticum aestivum) and maize (Zea mays) was tested during...

Stocker, S.; Weihs, D., 1998: Bird migration - an energy-based analysis of costs and benefits. We look at a model of migration as part of a whole ecological system. The purpose is to investigate the mutual relationship of population dynamics and migration strategies. In particular, we deal with the question of justifying the cost and danger...

Mcneill, L.S.; Edwards, M., 2001: Iron pipe corrosion in distribution systems. Iron pipe corrosion is extremely complicated and is affected by practically every physical, chemical, and biological parameter in water distribution systems. This work provides a summary of key factors that utilities must evaluate in order to miti...

Mueller, L.A.; Camilleri, M.; Emslie-Smith, A.M., 1999: Mitochondrial neurogastrointestinal encephalomyopathy: manometric and diagnostic features. Gastroenterology 116(4): 959-963

Doi, T.; Ohmori, H., 1993: Acetylcholine increases intracellular Ca2+ concentration and hyperpolarizes the guinea-pig outer hair cell. Extracellularly applied acetylcholine (ACh) induced outward currents in isolated outer hair cells of a guinea-pig cochlea. The ACh induced current was carried by K+ ions. The current amplitude was ACh dose dependent with a KD of 12 microM. The ACh...

Bush, R.A.; Lei, B.; Tao, W.; Raz, D.; Chan, C-Chao.; Cox, T.A.; Santos-Muffley, M.; Sieving, P.A., 2004: Encapsulated cell-based intraocular delivery of ciliary neurotrophic factor in normal rabbit: dose-dependent effects on ERG and retinal histology. PURPOSE. ERG and histologic changes were investigated in normal rabbits after intravitreal implantation of encapsulated cell technology (ECT) devices releasing ciliary neurotrophic factor ( CNTF). METHODS. Fifteen adult New Zealand White albino ra...