Hartmann A, Kühn J, Hopf R, Klepzig H, Standke R, Kober G, Maul F D, Hör G, Kaltenbach M
Department of Cardiology, Johann Wolfgang Goethe-University, Medical School, Frankfurt, FRG.
Cardiology. 1992;80(2):81-8. doi: 10.1159/000174983.
In 19 patients with hypertrophic cardiomyopathy (15 males, 4 females, mean age 49.2 +/- 10.8 years) left ventricular function was studied with radionuclide ventriculography at rest and during exercise in a crossover design without intervention and after disopyramide and propranolol treatment. 15 of the 19 patients had a resting or latent intraventricular gradient of more than 30 mm Hg. Left ventricular function at rest and during exercise was evaluated before medication, 90 min after oral administration of 200 mg disopyramide or 160 mg propranolol and after 3 weeks of oral therapy with disopyramide 200 mg 2 times a day or propranolol 80 mg 4 times a day. After long-term treatment with disopyramide, resting ejection fraction decreased from 72 +/- 12 to 69 +/- 14% (p less than 0.01) and peak ejection rate (PER) decreased from 3.46 +/- 135 to 3.24 +/- 65 end-diastolic volume (EDV).s-1 (p less than 0.01). Peak filling rate (PFR) at rest decreased from 3.01 +/- 0.8 to 2.77 +/- 0.63 EDV.s-1 (p less than 0.05). Time to peak filling rate (TPFR) at rest and during exercise after acute and chronic therapy did not change compared to control values. Acute and long-term administration of propranolol lead to a significant reduction in heart rate at rest and during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
对19例肥厚型心肌病患者（15例男性，4例女性，平均年龄49.2±10.8岁）采用交叉设计，在静息和运动状态下，于未干预时、服用双异丙吡胺和普萘洛尔治疗后，通过放射性核素心室造影研究左心室功能。19例患者中有15例静息或潜在的心室内压差超过30 mmHg。在用药前、口服200 mg双异丙吡胺或160 mg普萘洛尔90分钟后以及每天2次口服200 mg双异丙吡胺或每天4次口服80 mg普萘洛尔3周后，评估静息和运动时的左心室功能。长期服用双异丙吡胺后，静息射血分数从72±12%降至69±14%（p<0.01），射血峰值速率（PER）从3.46±135降至3.24±65每搏末舒张末期容积（EDV）·秒-1（p<0.01）。静息时的峰值充盈率（PFR）从3.01±0.8降至2.77±0.
