Nakatani M, Shirotani T, Kobayashi K, Satomi S, Ikeda Y, Kuniyoshi T, Tajiri E, Furuta Y, Motooka T
Department of Internal Medicine, Kasai Municipal Hospital, Hyogo.
J Cardiol. 1999 Aug;34(2):79-83.
The acute and chronic efficacy of low dose pimobendan (1.25 mg x 2/day) was evluated in patients with cor-pulmonale. Fifteen patients (12 men, 3 women, mean age 73 +/- 5 yr) with right ventricular dysfunction judged by Tei's Doppler index (> or = 0.4) and poor working capacity (exercise tolerance: 2.2-6.6 MET) were studied. Mean pulmonary artery pressure, cardiac output, total pulmonary resistance using Swan-Ganz catheter, and arterial oxygen and carbon dioxide pressure (PaO2, PaCO2) were measured before and 24 hr after pimobendan administration. Maximal oxygen intake (MET), saturation of arterial blood oxygen at rest and desaturation by treadmill stress test were measured before and 1 month after pimobendan administration. Pulmonary artery pressure decreased (17.6 +/- 4.7 to 10.2 +/- 2.3 mmHg, p < 0.001) and cardiac output increased (3.5 +/- 0.6 to 5.1 +/- 0.9 l/min, p < 0.001), resulting in decreased total pulmonary resistance (5.0 +/- 1.3 to 2.1 +/- 0.7 U, p < 0.001), and a mild decrease in PaO2 (74 +/- 8 to 70 +/- 10 mmHg, p < 0.05). Exercise tolerance improved significantly (4.8 +/- 1.7 to 6.8 +/- 2.2 MET, p < 0.001), without deterioration of PaO2 and desaturation. These results indicate that low dose pimobendan is useful for the treatment of patients with cor-pulmonale.
评估了低剂量匹莫苯丹（1.25毫克×每日2次）对肺心病患者的急慢性疗效。研究了15例患者（12例男性，3例女性，平均年龄73±5岁），这些患者经Tei氏多普勒指数判断存在右心室功能障碍（≥0.4）且工作能力较差（运动耐量：2.2 - 6.6代谢当量）。在给予匹莫苯丹之前和给药后24小时，使用Swan - Ganz导管测量平均肺动脉压、心输出量、总肺阻力，以及动脉血氧和二氧化碳分压（PaO2、PaCO2）。在给予匹莫苯丹之前和给药后1个月，测量最大摄氧量（代谢当量）、静息时动脉血氧饱和度以及通过平板运动试验的血氧饱和度下降情况。肺动脉压降低（从17.6±4.7降至10.2±2.3 mmHg，p < 0.001），心输出量增加（从3.5±0.6升至5.1±0.9升/分钟，p < 0.001），导致总肺阻力降低（从5.0±1.3降至2.1±0.7单位，p < 0.001），PaO2轻度降低（从74±8降至70±10 mmHg，p < 0.05）。运动耐量显著改善（从4.8±1.7升至6.8±2.2代谢当量，p < 0.001），且PaO2和血氧饱和度下降情况未恶化。这些结果表明低剂量匹莫苯丹对肺心病患者的治疗有效。
