The antiarrhythmic effect of nortriptyline in cardiac patients with ventricular premature depolarizations.
The antiarrhythmic effect of nortriptyline in cardiac patients with ventricular premature depolarizations.
复制标题
去甲替林对心室早除极心脏病患者的抗心律失常作用。
DOI：
10.1016/s0735-1097(86)80158-9
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发表时间：
1986
影响因子：
24
通讯作者：
Louie,M
中科院分区：
文献类型：
--
作者：
Giardina,EG;Barnard,T;Johnson,L;Saroff,AL;BiggerJr,JT;Louie,M
在16例每小时发生30次或以上室性早搏的心脏病患者中测定去甲替林抗室性心律失常的作用。去甲替林经口给药，0.5 mg/kg体重/天，每3天增加0.5 mg/kg/天，直至室性期前除极受到抑制（≥80%）、发生不良反应或每日总剂量达到3.5 mg/kg/天。每位患者每天进行24小时连续心电图、12导联标准心电图和体格检查;每天4次测量仰卧位和站立位血压。每例患者还在静息时进行放射性核素血管造影，以测量有效或最大剂量前和剂量下的射血分数。13例患者（81%）有抗疟反应，11例符合至少80%改善的研究标准。剂量范围为50 - 200 mg/天（平均111 ± 45），稳态血浆浓度范围为46 - 410 ng/ml（平均153 ± 96），去甲替林的消除半衰期为4 - 22小时（平均13 ± 4）。去甲替林给药未降低平均射血分数（给药前为42 ± 12%，给药后为41 ± 12%）;与收缩压直立性降低（平均-13 ± 13 mm Hg）相关。去甲替林是一种有效的抗心律失常药物，即使在心室功能受损的患者中也可每日给药两次。
The effect of nortriptyline against ventricular arrhythmias was determined in 16 cardiac patients with 30 or more ventricular premature depolarizations per hour. Nortriptyline was administered orally, 0.5 mg/kg body weight per day, and increased by 0.5 mg/kg per day every third day until ventricular premature depolarizations were suppressed (≥80%), adverse effects occurred or a total daily dose of 3.5 mg/kg per day was given. Each patient had daily 24 hour continuous electrocardiograms, 12 lead standard electrocardiograms and physical examination; blood pressure was measured in the supine and standing position four times a day. Each patient also had radionuclide angiography at rest to measure ejection fraction before and at the effective or maximal dose. Thirteen patients (81%) had an antiarrhythmic response and 11 met the study criterion of at least 80% improvement. Doses ranged from 50 to 200 mg/day (mean 111 ± 45), steady state plasma concentration ranged from 46 to 410 ng/ml (mean 153 ± 96) and half-life of elimination of nortriptyline was 4 to 22 hours (mean 13 ± 4). Administration of nortriptyline did not depress mean ejection fraction (before 42 ± 12%, after 41 ± 12%); it was associated with an orthostatic decrease in systolic blood pressure (mean -13 ± 13 mm Hg). Nortriptyline is an effective antiarrhythmic agent which may be given twice a day even in patients with impaired ventricular function.