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April 11, 1980

Calcium Antagonists for Hypertrophic Cardiomyopathy

JAMA. 1980;243(14):1464. doi:10.1001/jama.1980.03300400048033

Contrasting with the cornucopia of synonyms for hypertrophic cardiomyopathy, the scarcity of its therapeutic options is striking indeed. The only alternative to propranolol hydrochloride for the relief of obstruction to the left ventricular outflow tract has been septal myotomy-myectomy. When β-adrenergic blockade proves ineffective, as it not infrequently does, and if surgery is contraindicated, the patient has nowhere to turn for help.

Recent trials with a calcium antagonist, verapamil, hold out a strong hope for a pharmacologic alternative. In an earlier communication (1976), Kaltenbach and associates1 reported impressive symptomatic improvement in patients treated with oral verapamil for an average of 12 months. In a later report2 on their expanded study, this group of investigators described favorable results in 40 patients treated for three to 56 months (mean, 26 months) with verapamil in oral dosages of 480 to 720 mg/day. Not only did the drug relieve symptoms and improve