Possibilities of a differentiated approach to the treatment of patients with idiopathic hypertrophic subaortic stenosis
Fedorova, I.F.
Vestnik Akademii Meditsinskikh Nauk SSSR 1984(2): 52-55
1984
ISSN/ISBN: 0002-3027 PMID: 6538734 Document Number: 221559
The effects of .beta.-adrenoreceptor blockers and Ca antagonists on the central hemodynamics and the degree of the pressure gradient in the left ventricular efferent tract in patients with idiopathic hypertrophic subaortal stenosis, 16 patients were injected under echocardiographic control with 5 mg propranolol and 10 mg isoptin after 48-72 h. Following i.v. injection of propranolol 28.6% of patients demonstrated an increase in the standardized pressure gradient in the left ventricular efferent tract. After isoptin administration more demonstrable positive shifts in the central hemodynamics and reduction in the standardized pressure gradient were recorded in a group of patients with normal ejection fraction (< 0.75%). The treatment of patients with idiopathic hypertrophic subaortal stenosis should be differentiated, while adequate therapy chosen on the basis of the central hemodynamic parameters calculated according to the echocardiogram. In normal (< 0.85) ejection fraction, the patients should be treated with Ca antagonists. An increase in the standardized pressure gradient in the left ventricular efferent tract induced by trial i.v. injection of propranolol evidences that .beta.-adrenoreceptor blockers are contraindicated in the treatment of such patients.