Antiarrhythmic drug, cibenzoline, can directly improve the left ventricular diastolic function in patients with hypertrophic cardiomyopathy

Abstract

The effect of cibenzoline on left ventricular diastolic function was investigated in patients with hypertrophic cardiomyopathy (HCM). Before and 2h after an oral administration of 200 mg of cibenzoline, echocardiographic, apexcardiographic and gated radionuclide angiographic studies were performed in 12 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 7 with hypertrophic nonobstructive cardiomyopathy (HNCM). After administration of cibenzoline, the left ventricular pressure gradient decreased from 96±33 mmHg to 29±22 mmHg (<0.0001). Fractional shortening decreased from 53.3±7.5 to 45.4±6.2% (p=0.0008) in patients with HOCM and from 49.9±8.7 to 40.9±7.5% (p=0.0039) in patients with HNCM. On the other hand, E-wave velocity increased and A-wave velocity decreased in both groups. The time between the second heart sound and O point was shortened from 253±53 to 176±21 ms (p<0.0001) in patients with HOCM and from 245±54 to 185±44 ms (p=0.0050) in patients with HNCM. The time to peak filling rate was shortened from 248±79 to 190±40 ms (p=0.0072) in patients with HOCM and from 218±33 to 163±26 ms (p=0.0052) in patients with HNCM. These results indicate that in patients with HCM, cibenzoline suppresses left ventricular systolic function, but can markedly improve left ventricular diastolic dysfunction through its direct action.