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塞利洛尔对高血压患者心脏肥大的影响。

Effect of celiprolol on cardiac hypertrophy in hypertension.

作者信息

Haneda T, Ogawa Y, Kato J, Matsuhashi H, Morimoto H, Honda H, Takenaka T, Tanazawa S, Kataoka R, Kikuchi K

机构信息

First Department of Internal Medicine, Asahikawa Medical College, Japan.

出版信息

Hypertens Res. 2000 Sep;23(5):467-74. doi: 10.1291/hypres.23.467.

Abstract

The present study was undertaken to clarify whether celiprolol and atenolol, beta1-selective beta blockers with and without intrinsic sympathomimetic activity (ISA), respectively, might improve ischemic damage in the isolated perfused hearts of spontaneously hypertensive rats (SHR), and whether long-term treatment with celiprolol may reduce left ventricular hypertrophy (LVH) in patients with essential hypertension. Atenolol (50 mg/kg/day) or celiprolol (300 mg/kg/day) for 7 weeks significantly reduced the blood pressure in SHR to the same degree, and both drugs decreased the heart rate, but the magnitude of the fall in heart rate was significantly higher with atenolol treatment than with celiprolol treatment. Both treatments significantly reduced the ratio of LV weight to body weight in SHR and significantly improved the coronary reserve in SHR to the same extent. Both treatments significantly improved the extent of recovery of the pressure-rate product and the extent of percent recovery of the coronary flow after reperfusion following 30 min of ischemia in SHR. Celiprolol treatment in patients with essential hypertension for 12 months significantly decreased interventricular septal thickness (IVST)+LV posterior wall thickness (PWT) and LV mass index (LVMI), but there was no significant correlation between IVST+PWT or LVMI and blood pressure before and after treatment. IVST+PWT and LVMI were significantly decreased after 3 months of treatment and these LVH indices were significantly smaller after 6 and 12 months of treatment than after 3 months of treatment. In conclusion, both celiprolol and atenolol treatment reduced LVH and improved the ischemic damage in SHR. In essential hypertensive patients with LVH, celiprolol treatment effectively reduced blood pressure and achieved LVH regression.

摘要

本研究旨在阐明分别具有和不具有内在拟交感活性(ISA)的β1选择性β受体阻滞剂塞利洛尔和阿替洛尔是否能改善自发性高血压大鼠(SHR)离体灌注心脏的缺血损伤,以及塞利洛尔长期治疗是否能减轻原发性高血压患者的左心室肥厚(LVH)。阿替洛尔(50mg/kg/天)或塞利洛尔(300mg/kg/天)治疗7周可使SHR血压显著降低至相同程度,两种药物均使心率下降,但阿替洛尔治疗导致的心率下降幅度显著高于塞利洛尔治疗。两种治疗均显著降低了SHR的左心室重量与体重之比,并在相同程度上显著改善了SHR的冠脉储备。两种治疗均显著改善了SHR缺血30分钟后再灌注时压力-心率乘积的恢复程度以及冠脉血流的恢复百分比。原发性高血压患者接受塞利洛尔治疗12个月可显著降低室间隔厚度(IVST)+左心室后壁厚度(PWT)以及左心室质量指数(LVMI),但治疗前后IVST+PWT或LVMI与血压之间无显著相关性。治疗3个月后IVST+PWT和LVMI显著降低,且这些LVH指标在治疗6个月和12个月后显著小于治疗3个月后。总之,塞利洛尔和阿替洛尔治疗均减轻了SHR的LVH并改善了其缺血损伤。在伴有LVH的原发性高血压患者中,塞利洛尔治疗有效降低了血压并实现了LVH的逆转。

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