Combined nifedipine and propranolol therapy was evaluated in 15 patients with hypertrophic cardiomyopathy, but clinical outcomes are not reported in the provided text.
Observational (n=15)
No
Does combined nifedipine and propranolol therapy improve clinical symptoms and cardiac structure in patients with hypertrophic cardiomyopathy?
Combined nifedipine and propranolol therapy in hypertrophic cardiomyopathy is associated with clinical deterioration and adverse structural changes, suggesting high-dose verapamil is a superior strategy.
Fifteen (14 male and one female) patients with hypertrophic cardiomyopathy, ranging from 22 to 67 (mean: 45.5) years of age were treated with oral nifedipine and propranolol for 6 to 24 (mean:18) months. Twelve of the patients had been pretreated with a mean oral dose of 560 mg verapamil for 60 up to 93 (mean: 78.5) months, showing slight subjective and objective improvement. Treatment with nifedipine-propranolol was terminated in five cases due to deterioration or side effects after 6 and 12 months, respectively. During combined therapy, two patients reported subjective improvement, but in five cases there was no change and eight patients reported deterioration. The mean Sokolow-index showed no change. The radiologically determined heart volume increased in 11/15 patients and significantly in the mean of all patients from 887 +/- 239 to 947 +/- 246 ml/m2. In addition, echocardiographic measurements showed a significant increase in left atrial diameter from 40.0 +/- 9 to 42.1 +/- 9 mm, whereas ventricular wall thickness remained unchanged. Thus, high dose verapamil therapy seems superior to nifedipine-propranolol therapy in most patients with hypertrophic cardiomyopathy.
Hopf et al. (Fri,) conducted a observational in Hypertrophic cardiomyopathy (n=15). Nifedipine and propranolol vs. Baseline was evaluated. Combined nifedipine and propranolol therapy was evaluated in 15 patients with hypertrophic cardiomyopathy, but clinical outcomes are not reported in the provided text.