CARDIOVASCULAR EFFECTS OF TRICYCLIC ANTIDEPRESSANTS

我们对三环类药物丙咪嗪和去甲替林的研究已经测试了 假设它们对患有室性早搏的心脏病患者具有抗心律失常作用， 此外，还鉴定了一类新的抗心律失常药物。这个 行动持续时间长，消除半衰期长，缺乏 对心脏功能和射血分数的不良影响，以及相对 不限制长期治疗的轻微不良反应包括 显著优于许多市场上销售的代理和可用于 临床试验。具有讽刺意味的是，三轮车有可能 在心脏病患者中广泛使用，因为它们已经被 很大程度上是因为与过量服药相关的影响。我们 计划研究以比较这一新类别的有效性和耐受性 针对标准抗心律失常药物的药物；测试它们在 使用程序化电生理刺激的高危患者；以及 为了进一步研究它们在体内的药代动力学和蛋白质结合 慢性稳定型室间隔缺损和心肌梗死患者。这些研究 是为了加强我们对动力学和动力学的理解 以前没有接触过三环素的人群中，以及他们的 正常志愿者和抑郁症患者的行为无法从报告中预测 病人。我们的长期目标是改善我们合理使用 我国优秀的新型抗心律失常药物慢性口服治疗 心脏病患者。

Our studies with the tricyclics, imipramine and nortriptyline, have tested the hypothesis they are antiarrhythmic in cardiac patients with VPDs and, moreover, have identified a new class of antiarrhythmic agents. The sustained duration of action, long half-life of elimination, lack of adverse effect on cardiac function and ejection fraction, and relatively minor adverse effects which do not limit long-term treatment are significant advantages over many marketed agents and those available for clinical trials. It is ironical that tricyclics have a potential for widespread use in cardiac patients in view of the fact they have been largely withheld from them because of effects associated with overdose. We plan studies to compare effectiveness and tolerance of this new class of agents against a standard antiarrhythmic drug; to test their efficacy in high risk patients using programmed electrophysiological stimulation; and to further characterize their pharmacokinetics and protein binding in patients with chronic stable VPDs and myocardial infarction. These studies are designed to enhance our understanding of the dynamics and kinetics of tricyclics in populations not previously exposed to them and in whom their behavior is not predictable from reports in normal volunteers and depressed patients. The long term goal is to improve our rational use of an outstanding new class of antiarrhythmic drugs for chronic oral therapy in cardiac patients.