CHRONIC EFFECTS OF AMIODARONE IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

胺碘酮对肥厚性心肌病患者的慢性影响

• 批准号: 4694676
• 负责人: M B LEON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/4694676
• 关键词: antiarrhythmic agent; benzofurans; beta antiadrenergic agent; calcium channel blockers; cardiovascular stress test; cineangiocardiography; dosage; drug administration rate /duration; heart disorder chemotherapy; heart pharmacology; human subject; human therapy evaluation; hypertrophic myocardiopathy; tachycardia

We have previously found that high dose oral amiodarone (1200-1600 mg/day for 10 days) improves cardiac symptoms, prolonges exercise capacity, and reduces significant ventricular arrhythmias in patients with nonbstructive hypertrophic cardiomyopathy and severe cardiac symptoms. The present investigation was designed to assess the chronic effects of amiodarone in the same patient group while on lower dose maintenance therapy (400-600 mg/day for 2 months). Efficacy was determined by exercise testing, ambulatory ECG monitoring, radionuclide cine-angiography, and semiquantitative symptoms score analysis. We found that exercise capacity improved significantly during chronic oral therapy in association with a reduction in the semiquantitative symptoms scores. The clinical responses were varied; one patient died suddenly despite improved symptoms and no ventricular arrhythmias, two others required the addition of calcium channel blockers, one had progressed to left ventricular myectomy, and 6 patients had satisfactory symptom control. It is our impression that amiodarone may prove to be significant tool in the pharmacologic armamentarium in the treatment of patients with hypertrophic cardiomyopathy. In addition to its important effects on both supraventricular and ventricular arrhythmias, amiodarone improves cardiac symptoms and restores functional capacity in many patients with hypertrophic cardiomyopathy who have been refractory to standard medical including calcium channel blockers and beta blockers.

我们以前发现，高剂量口服胺碘酮（1200 - 1600 mg/天 10天）改善心脏症状，提高运动能力， 减少非阻塞性心律失常患者的显著室性心律失常 肥厚型心肌病和严重的心脏症状。 本 一项研究旨在评估胺碘酮在 相同的患者组，而在较低剂量的维持治疗（400 - 600 mg/天，持续2个月）。 通过运动试验确定疗效， 动态心电图监测、放射性核素电影血管造影，以及 半定量症状评分分析。 我们发现运动能力 在慢性口服治疗期间， 半定量症状评分降低。 的临床反应 不同;一名患者突然死亡，尽管症状改善，没有 室性心律失常，另外两个需要补充钙 通道阻滞剂，1例进展为左心室肌切除术，6例 患者症状控制满意。 我们的印象是， 胺碘酮可能被证明是药理学上的重要工具 在治疗肥厚性甲状腺肿患者中的应用 心肌病 除了对两者的重要影响外， 室上性和室性心律失常，胺碘酮改善心脏 症状和恢复功能的能力，在许多患者 标准药物治疗无效的肥大性心肌病 包括钙通道阻滞剂和β阻滞剂。