Gabrusenko S A, Naumov V G, Khodzhakuliev B G, Masenko V P, Belenkov Iu N
Kardiologiia. 1992 Apr;32(4):20-4.
Ventricular arrhythmias were analysed in 38 patients with Stages I-IIB heart failure from 24-hour Holter monitoring data obtained before and after digoxin therapy by comparing with the concentrations of catecholamines. There was a direct relationship between the plasma levels of epinephrine and norepinephrine and the severity of ventricular arrhythmias, as well as between the changes in cumulative catecholamine levels and ventricular arrhythmias during digoxin therapy. Virtually in all cases, the antiarrhythmic effect of the drug was accompanied by lower plasma catecholamine concentrations whereas the levels of norepinephrine and epinephrine remained nearly unchanged or increased with the tentatively arrhythmogenic action. The findings may suggest that hypercatecholaminemias are essential in the genesis of ventricular arrhythmias in heart failure. Cardiac glycosides can heterogeneously affect ventricular arrhythmias by modifying the activity of the sympathoadrenal system.
通过比较儿茶酚胺浓度，对38例I-IIB期心力衰竭患者地高辛治疗前后获得的24小时动态心电图监测数据中的室性心律失常进行了分析。肾上腺素和去甲肾上腺素的血浆水平与室性心律失常的严重程度之间存在直接关系，地高辛治疗期间累积儿茶酚胺水平的变化与室性心律失常之间也存在直接关系。几乎在所有情况下，药物的抗心律失常作用伴随着血浆儿茶酚胺浓度降低，而去甲肾上腺素和肾上腺素水平在有暂定致心律失常作用时几乎保持不变或升高。这些发现可能提示高儿茶酚胺血症在心力衰竭室性心律失常的发生中至关重要。强心苷可通过改变交感肾上腺系统的活性对室性心律失常产生不同影响。
