Zaliūnas Remigijus, Brazdzionyte Julija, Zabiela Vytautas, Jurkevicius Renaldas
Eiveniu 2, Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
Int J Cardiol. 2005 Jun 8;101(3):347-53. doi: 10.1016/j.ijcard.2004.03.040.
To estimate the influence of therapy with amlodipine (A) or lacidipine (L) on heart rate variability (HRV) time and frequency domain parameters in hypertensive patients with stable angina pectoris and isolated left ventricular diastolic dysfunction.
After a 1-week washout period, the patients were randomized to receive amlodipine 10 mg (30 patients) or lacidipine 6 mg (30 patients) once-daily for 4 weeks. HRV parameters were determined over a period of 24 h, echocardiography and exercise test were performed before and after treatment.
All HRV time domain parameters after applying amlodipine did not change significantly. A reliable decrease only of the root mean square of differences between adjacent normal-to-normal intervals (RMSSD)-32.9 +/- 13 vs. 27.5 +/- 9-was noticed after treatment with lacidipine. In the lacidipine group, the change of RMSSD negatively correlated with the extent of ST segment depression during exercise testing (R = -0.43; P < 0.05). Both drugs reduced total power (A, 2234 +/- 1270 vs. 1813 +/- 889; L, 2205 +/- 1151 vs. 1825 +/- 896; P < 0.01), very low (A, 1451 +/- 733 vs. 1143 +/- 534; L, 1413 +/- 759 vs. 1213 +/- 616; P < 0.05), and low frequency power (A, 610 +/- 459 vs. 447 +/- 321; L, 569 +/- 323 vs. 442 +/- 241; P < 0.01). After amlodipine, high frequency power remained unchanged, whereas low-high frequency ratio decreased (4.54 +/- 1.72 vs. 3.77+/-1.73; P < 0.05). After lacidipine, high frequency power decreased (178.8 +/- 153.2 vs. 132.1 +/- 79.3; P < 0.05), whereas the ratio of low frequency to high frequency did not change.
Amlodipine and lacidipine reduce the influence of humoral control and sympathetic autonomic nervous system activity. The autonomic balance becomes shifted toward the increased vagal activity only by amlodipine.
评估氨氯地平（A）或拉西地平（L）治疗对稳定型心绞痛合并孤立性左心室舒张功能障碍高血压患者心率变异性（HRV）时域和频域参数的影响。
经过1周的洗脱期后，将患者随机分为两组，一组每日服用氨氯地平10mg（30例患者），另一组每日服用拉西地平6mg（30例患者），共治疗4周。在24小时内测定HRV参数，治疗前后进行超声心动图和运动试验。
应用氨氯地平后，所有HRV时域参数均无显著变化。服用拉西地平治疗后，仅相邻正常RR间期差值的均方根（RMSSD）有可靠的降低，从32.9±13降至27.5±9。在拉西地平组，RMSSD的变化与运动试验期间ST段压低的程度呈负相关（R = -0.43；P < 0.05）。两种药物均降低了总功率（A组，2234±1270 vs. 1813±889；L组，2205±1151 vs. 1825±896；P < 0.01）、极低频功率（A组，1451±733 vs. 1143±534；L组，1413±759 vs. 1213±616；P < 0.05）和低频功率（A组，610±459 vs. 447±321；L组，569±323 vs. 442±241；P < 0.01）。服用氨氯地平后，高频功率保持不变，而低频与高频比值降低（4.54±1.72 vs. 3.77±1.73；P < 0.05）。服用拉西地平后，高频功率降低（178.8±153.2 vs. 132.1±79.3；P < 0.05），而低频与高频比值未改变。
氨氯地平和拉西地平可降低体液控制和交感自主神经系统活动的影响。仅氨氯地平可使自主神经平衡向迷走神经活动增加的方向转变。
