The effects of esmolol by vein injection on cardiac function in patients with hypertrophic cardiomyopathy

Objective To study the effects of esmolol on hemodynamic and left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy(HCM).Methods The echocardiography and left ventricular catheterization were performed simultaneously in 13 patients with HCM(9 cases without obstruction,4 cases with obstruction) to observe the left ventricular systolic and diastolic function before and after esmolol injection.Results Left ventricular ejection fraction,heart rate,systolic blood pressure,and left ventricular systolic pressure were reduced significantly after intravenous esmolol(P0.05～0.001).There was obvious change in diastolic pressure and maximum upstroke velocity of left ventricular pressure.In 4 patients with obstructive HCM,esmolol decreased left ventricular outflow tract gradient significantly((57.00±9.2) vs(23.27±12.96) mmHg,P0.05).Left ventricular relaxation time constant,dp/dtmax and chamber stiffness were not altered.Left ventricular end diastolic pressure obviously decreased((19.62±10.55) vs(11.18±7.58)mmHg,P0.05).Conclusions Esmolol could improve left ventricular compliance through reducing left ventricular contractility,loading condition and heart rate,especially in obstructive HCM patients.