Kihara K, Koga Y, Wada T, Toshima H
Third Department of Medicine, Kurume University School of Medicine, Japan.
Jpn Circ J. 1992 Jan;56(1):77-85. doi: 10.1253/jcj.56.77.
Antiarrhythmic effects of beta-blockade (BB) in patients with dilated cardiomyopathy were compared with those of various antiarrhythmic agents using ambulatory Holter monitoring. The BB therapy effectively suppressed ventricular extrasystoles (VEs) in 85% of patients, as evidenced by improvement in Lown's grade or a reduction in the number of the highest grade VEs greater than 50%. In contrast, conventional antiarrhythmic agents, except flecainaid and amiodarone, were poorly effective in suppressing VEs. BB therapy gradually increased left ventricular fractional shortening (16 +/- 6% to 22 +/- 12%) and improved 12-month survival rates as compared with those receiving conventional therapy (93 vs 69%). This antiarrhythmic potency seemed to be an additional therapeutic efficacy of BB in the management of patients with dilated cardiomyopathy, which frequently associated with serious VEs.
通过动态心电图监测，比较了β受体阻滞剂（BB）与各种抗心律失常药物对扩张型心肌病患者的抗心律失常作用。BB治疗有效抑制了85%患者的室性早搏（VEs），Lown分级改善或最高级VEs数量减少超过50%证明了这一点。相比之下，除氟卡尼和胺碘酮外，传统抗心律失常药物在抑制VEs方面效果不佳。与接受传统治疗的患者相比，BB治疗使左心室短轴缩短率逐渐增加（从16±6%增至22±12%），并提高了12个月生存率（93%对69%）。这种抗心律失常效力似乎是BB在治疗经常伴有严重VEs的扩张型心肌病患者时的额外治疗效果。
