AMIODARONE IMPROVES RAPID DIASTOLIC FILLING IN PATIENTS WITH HCM

虽然我们已经证明胺碘酮可以提高运动能力， 减少心脏症状，并减少频率和严重性 肥厚型心肌病患者的复杂室性心律失常 心肌病，其作用机制尚未明确。 因此，我们研究了30例肥厚型心肌病患者， 负荷剂量前后放射性核素血管造影技术 （1200-1600 mg/天，持续10天）和维持剂量（400-600 mg/天，持续2天 月）胺碘酮。 我们检查了左心室功能的变化， 在心脏收缩期和心脏舒张期。 左室舒张期快速充盈 通过检查LV充盈的峰值速率和LV充盈的幅度进行评估。 快速舒张期充盈期间充盈的每搏输出量。 我们发现 绝大多数患者的比率和 初始胺碘酮治疗后快速舒张充盈的幅度。 虽然胺碘酮维持治疗期间的变化不那么引人注目， 所有充盈峰值速率或充盈幅度 与负荷剂量治疗相比， 更严重的心脏症状。 因此，胺碘酮似乎 改善肥厚型心肌病患者的舒张期充盈特征 心肌病与快速舒张期充盈变化平行临床 status. 这些数据表明，改善的快速舒张充盈可能是一种 影响胺碘酮临床疗效重要机制 治疗这样的病人。

Although we have demonstrated that amiodarone improve exercise capacity, reduces cardiac symptoms, and diminishes the frequency and severity of complex ventricular arrhythmias in patients with hypertrophic cardiomyopathy, its mechanisms of action have been poorly defined. Therefore, we studied 30 patients with hypertrophic cardiomyopathy using radionuclide angiographic techniques before and after loading dose (1200-1600 mg/day for 10 days) and maintenance dose (400-600 mg/day for 2 months) amiodarone. We examined left ventricular functional changes both during systole and diastole. Left ventricular rapid diastolic filling was assessed by examining the peak rate of LV filling and the magnitude of LV stroke volume filled during rapid diastolic filling. We found that the vast majority of patients manifested an improvement in both the rate and magnitude of rapid diastolic filling after initial amiodarone therapy. Although changes during maintenance amiodarone therapy were less striking, all patients in whomm the peak rate of filling or the magnitude of filling decreased compared to loading dose therapy also had reduced exercise capacity and worse cardiac symptoms. Thus, it appears that amiodarone improves diastolic filling characteristice in patients with hypertrophic cardiomyopathy and the changes in rapid diastolic filling parallel clinical status. This data suggest that improved rapid diastolic filling may be an important mechanism contributin to the clinical efficacy of amiodarone therapy in such patients.