Hemodynamic effects of nifedipine given alone and in combination with atenolol in patients with impaired left ventricular function.
Hemodynamic effects of nifedipine given alone and in combination with atenolol in patients with impaired left ventricular function.
复制标题
硝苯地平单独给药以及与阿替洛尔联用对左心室功能受损患者的血流动力学影响。
DOI：
10.1016/0002-9149(85)91206-8
复制
发表时间：
1985
期刊：
影响因子：
--
通讯作者：
D. Krikler
中科院分区：
文献类型：
--
作者：
M. de Buitléir;E. Rowland;D. Krikler
对 9 名左心室 (LV) 功能显着受损（放射性核素扫描射血分数 [EF] 为 0.20 至 0.40）的患者进行硝苯地平的急性静脉注射（IV）（每次 0.1、0.2 和 0.4 μg/kg/min，每次超过 10 分钟）和慢性口服（60 mg/天）给药，这些患者已接受 β 受体阻滞剂治疗（峰值运动心率降低 25% 以上），阿替洛尔，100至200毫克/天。整个组的心导管插入术时的平均对照 LV 舒张末压 (EDP) 和 EF 分别为 30 ± 3 mm Hg（范围 20 至 42）（平均值 ± 平均值的标准误差）和 28.5 ± 2.4%。 9 名患者中的 3 名出现血流动力学恶化和部分左心室衰竭。研究期间，他们的平均 LVEDP 和 EF 分别为 38 ± 3 mm Hg（范围 33 至 42）和 22.6 ± 2.7%。在耐受完整治疗方案的 6 名患者中，平均 LVEDP 和 EF 分别为 26.5 ± 2.0 mm Hg（范围 20 至 35）和 31.5 ± 2.8%。七名患者接受静脉注射硝苯地平，其具有负性肌力作用，但不会导致心脏代偿失调。长期口服硝苯地平联合阿替洛尔仅在 EF 最低和 LVEDP 最高的患者中引发左室衰竭；通常单用阿替洛尔会出现左心室衰竭。广泛的梗死，通常并发左心室衰竭，LVEDP > 32 mm Hg 和对照静息 EF < 30 % 与左心室衰竭相关。通过β受体阻滞剂去除对受损心室的交感神经系统支持可能是导致左室功能严重受损患者血流动力学恶化的决定性因素。
The acute intravenous (IV) (0.1, 0.2 and 0.4 μg/kg/min over 10 minutes each) and chronic oral (60 mg/day) administration of nifedipine was examined in 9 patients with significantly impaired left ventricular (LV) function (ejection fraction [EF] on radionuclide scannin was 0.20 to 0.40) who were already receiving β-blocker therapy (>25% reduction in peak exercise heart rate) with atenolol, 100 to 200 mg/day. The mean control LV end-diastolic pressure (EDP) at cardiac catheterization and EF for the group as a whole were 30 ± 3 mm Hg (range 20 to 42) (mean ± standard error of the mean) and 28.5 ± 2.4%, respectively. Three of the 9 patients had hemodynamic deterioration and LV failure at some. stage during the study, and their mean LVEDP and EF were 38 ± 3 mm Hg (range 33 to 42) and 22.6 ± 2.7%, respectively. In the 6 patients who tolerated the full treatment protocol, the mean LVEDP and EF were 26.5 ± 2.0 mm Hg (range 20 to 35) and 31.5 ± 2.8%, respectively. Seven patients received IV nifedipine, which had a negative inotropic action but did not precipitate cardiac decompensation. Chronic oral administration of nifedipine in combination with atenolol precipitated LV failure only in those with the lowest EF and highest LVEDP; usually LV failure was present with atenolol alone. Extensive infarction, frequently complicated by LV failure at the time, LVEDP >32 mm Hg and control resting EF <30 % were associated with LV failure. Removal of sympathetic nervous system support for the impaired ventricle by β blockade may be the decisive factor in precipitating hemodynamic deterioration in patients with severe impairment of LV function.
维拉帕米和硝苯地平对普萘洛尔患者的血流动力学和电生理影响。
DOI：
10.1016/0002-9149(82)91222-x
发表时间：
1982
期刊：
The American journal of cardiology
影响因子：
--
作者：
Winniford,MD;MarkhamJr,RV;Firth,BG;Nicod,P;Hillis,LD
通讯作者：
Hillis,LD