Effect of imipramine and nortriptyline on left ventricular function and blood pressure in patients treated for arrhythmias.
Effect of imipramine and nortriptyline on left ventricular function and blood pressure in patients treated for arrhythmias.
复制标题
丙咪嗪和去甲替林对心律失常治疗患者左心室功能和血压的影响。
DOI：
10.1016/0002-8703(85)90240-6
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发表时间：
1985
影响因子：
4.8
通讯作者：
Brem,RF
中科院分区：
文献类型：
--
作者：
Giardina,EG;Johnson,LL;Vita,J;BiggerJr,JT;Brem,RF
观察丙咪嗪和去甲替林对20例室性早搏（VPDs）患者左室功能和立位血压的影响。口服给药，使用的剂量范围为1 mg/kg/天（丙咪嗪）或0.5 mg/kg/天（去甲替林），在4次给药（丙咪嗪）或6次给药（去甲替林）后增加剂量，直至>80%的VPD抑制或发生不良反应，或直至给予最大剂量5 mg/kg/天（丙咪嗪）或3.5 mg/kg/天（去甲替林）。14例（70%）VPD抑制>80%，5例改善<80%（范围25%至77%），1例VPD频率增加6%。平均每日丙咪嗪剂量为210 ± 103 mg，平均去甲替林剂量为100 ± 29 mg。两种药物均未显著改变放射性核素血管造影的平均射血分数或收缩压峰值/收缩末期容积比。两种药物均降低了站立位收缩压：丙咪嗪治疗后的平均变化为26 mm Hg（NS），去甲替林治疗后为14 mm Hg（p< 0.05）。2例患者因症状性直立位血压变化> 30 mm Hg而停药。剂量、药物浓度或功能分级与收缩压的直立性变化无显著相关性，但与年龄有显著相关性（p< 0.05）。这些观察结果表明，即使心脏收缩功能受损的患者也可以服用丙咪嗪或去甲替林治疗VPD;然而，建议经常测量血压，特别是老年患者。
The effect of imipramine or nortriptyline on left ventricular function and orthostatic blood pressure was evaluated in 20 nondepressed cardiac patients treated for ventricular premature depolarizations (VPDs). Drug was administered by mouth and dose ranging used, 1 mg/kg/day (imipramine) or 0.5 mg/kg/day (nortriptyline), was increased after four doses (imipramine) or six doses (nortriptyline) until >80% suppression of VPDs or adverse effects occurred or until a maximum dose of 5 mg/kg/day (imipramine) or 3.5 mg/kg/day (nortriptyline) was given. Fourteen (70%) had >80% VPD suppression, five had <80% improvement (range 25% to 77%), and one had a VPD frequency increase of 6%. Mean daily imipramine dose was 210 ± 103 mg and mean nortriptyline dose was 100 ± 29 mg. Neither drug significantly changed mean ejection fraction or peak systolic pressure end-systolic volume ratio by radionuclide angiogram. Both reduced standing systolic blood pressure: mean change after imipramine was 26 mm Hg (NS), and after nortriptyline, 14 mm Hg (p< 0.05). Drug was discontinued in two patients because of symptomatic orthostatic blood pressure change > 30 mm Hg. There was not a significant relationship between dose, drug concentration, or functional class and orthostatic change in systolic blood pressure but there was for age (p< 0.05). These observations suggest that even cardiac patients with impaired systolic function may take imipramine or nortriptyline for VPDs; however, frequent blood pressure measurement is advised, particularly in older patients.