Sugiyama Atsushi, Satoh Yoshioki, Takahara Akira, Ando Kentaro, Nakamura Yuji, Hashimoto Keitaro
Department of Pharmacology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Tamaho-cho, Nakakoma-gun, Yamanashi, 409-3898, Japan.
Heart Vessels. 2005 May;20(3):112-5. doi: 10.1007/s00380-004-0817-1.
We encountered a 91-year-old woman with atrial fibrillation complicating bradycardia while she was receiving therapy with an L/N-type calcium channel blocker, cilnidipine, for hypertension, which is an unusual observation for the dihydropyridine class of calcium channel blockers. Therefore, we compared the dromotropic effect of cilnidipine with that of an L-type calcium channel blocker, nicardipine, which has a similar hypotensive activity. The canine isolated, blood-perfused atrioventricular node preparation was used. Cilnidipine as well as nicardipine slowed atrioventricular nodal conduction in a dose-related manner. However, the dromotropic action of cilnidipine was about five times less potent than that of nicardipine. These experimental results may suggest that we experienced an atypical clinical event of cilnidipine in a very old woman; otherwise one can speculate that the N-type calcium channel inhibitory component of cilnidipine might have played a role in exerting the negative dromotropic effect in this patient.
我们遇到一位91岁的女性，她在接受L/N型钙通道阻滞剂西尼地平治疗高血压时，房颤并发心动过缓，这对于二氢吡啶类钙通道阻滞剂来说是不寻常的观察结果。因此，我们比较了西尼地平与具有相似降压活性的L型钙通道阻滞剂尼卡地平的变时作用。使用犬离体、血液灌注房室结标本。西尼地平和尼卡地平均以剂量相关的方式减慢房室结传导。然而，西尼地平的变时作用比尼卡地平弱约五倍。这些实验结果可能表明，我们在一位非常老年的女性中遇到了西尼地平的非典型临床事件；否则，可以推测西尼地平的N型钙通道抑制成分可能在该患者中发挥了负性变时作用。
