Key result
Calcium inhibitors improved overall subjective symptoms in 33% of patients with hypertrophic cardiomyopathy compared to 50% with beta-blockers, but were superior in completely suppressing angina pectoris.
Why the study?
Do calcium inhibitors improve symptoms and clinical parameters compared to beta-blockers in patients with hypertrophic cardiomyopathy?
Observational (n=16)
No
Do calcium inhibitors improve symptoms and clinical parameters compared to beta-blockers in patients with hypertrophic cardiomyopathy?
In a small cohort of patients with hypertrophic cardiomyopathy, beta-blockers provided better overall symptom relief but were associated with adverse long-term echocardiographic and electrocardiographic changes compared to calcium inhibitors.
Beta-blockers may offer better overall symptom relief yet risk adverse remodeling versus calcium inhibitors in hypertrophic cardiomyopathy; leaves open optimal selection pending randomized trials.
Long-term clinical effects of beta-blockers (propranolol in most cases) and calcium inhibitors (nifedipine in most cases) were studied in 16 patients with hypertrophic cardiomyopathy.On overall subjective symptoms, beta-blockers were effective in 50% of symptomatic patients, while calcium inhibitors were effective in only 33%. On angina pectoris, however, calcium inhibitors were superior to beta-blockers in our patients. Blood pressure decreased with each drug, and the decrease was significant with nifedipine. Otherwise there was no change in physical findings with either drug.Long-term (more than 6 months) use of beta-blockers resulted in an increase in cardiothoracic ratio on chest X-ray, a decrease in left ventricular ejection fraction on echocardiogram and more pronounced ST-T change on electrocardiogram. Prolonged use of nifedipine resulted in a slight decrease in cardiothoracic ratio, but no systematic change on echocardiogram and on electrocardiogram.
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KOIDE et al. (1981) conducted an observational in Hypertrophic cardiomyopathy (n=16). Calcium inhibitors (nifedipine, verapamil) vs. Beta-blockers (propranolol, oxprenolol, alprenolol) was evaluated on Overall symptomatic improvement. Calcium inhibitors improved overall subjective symptoms in 33% of patients with hypertrophic cardiomyopathy compared to 50% with beta-blockers, but were superior in completely suppressing angina pectoris.
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