Shiina H, Sugiyama A, Takahara A, Satoh Y, Hashimoto K
Second Department of Internal Medicine, Shinshu University, School of Medicine, Nagano, Japan.
Jpn Circ J. 2000 Oct;64(10):777-82. doi: 10.1253/jcj.64.777.
The cardiovascular profile of verapamil was assessed in the halothane-anesthetized canine model and compared with that of propranolol. Verapamil was infused at the rates of 1, 3 and 10 microg x kg(-1) x min(-1) (n=6), whereas propranolol was administered at a fixed rate of 10 microg x kg(-1) x min(-1) (n=6). Each infusion was performed over 30 min, and the parameters were assessed for 20-30 min after the start of each infusion. Verapamil in a dose of 10 microg x kg(-1) x min(-1) significantly suppressed atrio-ventricular (AV) node conduction and slightly decreased the mean blood pressure, but no significant change was detected in the left ventricular end-diastolic pressure, maximum upstroke velocity of the left ventricular pressure, sinus automaticity, double product, cardiac output, intraventricular conduction, and ventricular repolarization phase and refractoriness. Propranolol suppressed AV node conduction to an extent similar to that of verapamil, but it also inhibited intraventricular conduction, sinus automaticity and ventricular contraction, increased the ventricular refractoriness, and decreased the double product and cardiac output, without any significant change in the other variables measured. These results suggest that verapamil can selectively affect the AV node, and that the greater part of the suppressive action of propranolol on the multiple cardiovascular performance is through a beta-blocking action and direct membrane effect, although the halothane inhalation itself might have modified each of the drug's effects. The abbreviation of the relative refractory period of the ventricle by propranolol may show its potential utility for re-entry type ventricular tachycardia.
在氟烷麻醉的犬模型中评估了维拉帕米的心血管特性,并与普萘洛尔进行了比较。维拉帕米以1、3和10微克·千克⁻¹·分钟⁻¹的速率输注(n = 6),而普萘洛尔以10微克·千克⁻¹·分钟⁻¹的固定速率给药(n = 6)。每次输注持续30分钟,在每次输注开始后20 - 30分钟评估各项参数。剂量为10微克·千克⁻¹·分钟⁻¹的维拉帕米显著抑制房室(AV)结传导并轻微降低平均血压,但左心室舒张末期压力、左心室压力最大上升速度、窦性自律性、双乘积、心输出量、室内传导以及心室复极期和不应期均未检测到显著变化。普萘洛尔对AV结传导的抑制程度与维拉帕米相似,但它还抑制室内传导、窦性自律性和心室收缩,增加心室不应期,并降低双乘积和心输出量,而所测量的其他变量均无显著变化。这些结果表明,维拉帕米可选择性地影响AV结,并且普萘洛尔对多种心血管功能的抑制作用大部分是通过β受体阻滞作用和直接膜效应,尽管吸入氟烷本身可能改变了每种药物的作用。普萘洛尔使心室相对不应期缩短可能显示其对折返型室性心动过速具有潜在效用。