Effects of Various Doses of Intracoronary Diltiazem on Coronary Resistance Vessels in Humans

• Published in: JAPANESE CIRCULATION JOURNAL Vol. 59; no. 12; pp. 790 - 798
• Main Authors: Ishihara, Masaharu, Sato, Hikaru, Tateishi, Hironobu, Kawagoe, Takuji, Shimatani, Yuji, Ueda, Atsushi, Kurisu, Satoshi
• Format: Journal Article
• Language: English
• Published: Kyoto The Japanese Circulation Society 1995; Japanese Circulation Society
• Subjects: Aged; Antianginal agents. Coronary vasodilator agents; Biological and medical sciences; Blood Flow Velocity - drug effects; Calcium channel blocker; Calcium Channel Blockers - administration & dosage; Calcium Channel Blockers - pharmacology; Cardiovascular system; Coronary Angiography; Coronary Doppler guide wire; Coronary microcirculation; Coronary Vessels - drug effects; Coronary Vessels - physiopathology; Diltiazem; Diltiazem - administration & dosage; Diltiazem - pharmacology; Dose-Response Relationship, Drug; Female; Hemodynamics - drug effects; Humans; Injections, Intra-Arterial; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Vascular Resistance - drug effects; Vasodilation - drug effects; Vasodilator Agents - administration & dosage; Vasodilator Agents - pharmacology; Sonography; Doppler ultrasound study; Human; Chemotherapy; Treatment; Coronary vasodilator agent; Calcium antagonist; Coronary artery; Exploration; Intraarterial administration; Hemodynamics
• ISSN: 0047-1828; 1347-4839
• DOI: 10.1253/jcj.59.790

We investigated the vasodilative effects of various doses of intracoronary diltiazem on coronary resistance vessels. Nine patients with normal angiograms were studied. A coronary Doppler guide wire was inserted into the left anterior descending coronary artery. Diltiazem, in doses of 0.1 mg, 0.5 mg, 1.0 mg, 2.0 mg and 4.0 mg, was injected into the left coronary artery at 10 min intervals and coronary blood flow velocity was measured. The coronary artery was pretreated with intracoronary nitroglycerin to avoid changes in the cross-sectional area. As a measure of the change in coronary vascular resistance, a coronary vascular resistance index (CVRI) was calculated as mean aortic pressure/coronary blood flow velocity. An injection of diltiazem into the left coronary artery caused a significant dose-dependent decrease in CVRI. A dose of 2.0 mg was the lowest dose on the plateau of the dose-response curve. In conclusion, the injection of diltiazem into the left coronary artery causes a dose-dependent dilatation of coronary resistance vessels, and the maximal effect can be produced with a dose of 2.0 mg.