The hemodynamic effects of diltiazem were investigated in 15 patients with suspected coronary artery disease undergoing routine cardiac catheterization. Diltiazem was given in a high dose of 500 micrograms/kg over a period of 5 min and measurements made before and after drug administration during spontaneous heart rate and during matched atrial pacing. Spontaneous heart rate did not change (-5%; NS). Left ventricular (LV) systolic pressure decreased 24% (p less than 10(-6)) and LV end-diastolic pressure (LVEDP) did not change (-5%; NS). During coronary blood flow measurement, mean aortic pressure decreased 30% (p less than 10(-6)) as global (coronary sinus) and regional (great cardiac vein) coronary vascular resistance diminished with no change in coronary blood flow. Myocardial oxygen consumption decreased 19% (p less than 0.02). During matched pacing, although no change occurred in calculated systolic isovolumic indexes of contractility, end-systolic pressure-volume index decreased 15% (p less than 0.05). The time constant of isovolumic relaxation assessed by a biexponential model decreased. No net change occurred in either global or regional wall motion. In summary, high-dose diltiazem was administered safely to patients with coronary artery disease. It is concluded that, at this dose, diltiazem acted as a peripheral and coronary vasodilator. Hemodynamic changes consistent with a direct negative inotropic and chronotropic effect of the drug were observed. Myocardial oxygen consumption decreased with no change in coronary blood flow.

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Keywords 0 (Benzazepines), 42399-41-7 (Diltiazem), Aged, Benzazepines/*pharmacology, Blood Pressure/drug effects, Coronary Circulation/*drug effects, Coronary Disease/*physiopathology, Diltiazem/*pharmacology, Heart Rate/drug effects, Human, Injections, Intravenous, Male, Middle Aged, Myocardial Contraction/*drug effects, Myocardium/metabolism, Oxygen Consumption/drug effects, Support, U.S. Gov't, P.H.S., Vascular Resistance/drug effects
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Serruys, P.W.J.C., Suryapranata, H., Planellas, J., Wijns, W., Vanhaleweyk, G., Jaski, B.E., & Hugenholtz, P.G.. (1985). Effects of short-term intravenous administration of diltiazem on left ventricular function and coronary hemodynamics in patients with coronary artery disease. Journal of Cardiovascular Pharmacology, 7, 1138–1148. Retrieved from