Sievert H, Schmidt T, Frey G, Schräder R, van der Does R, Kaltenbach M, Kober G
Kardiologisches Fachkrankenhaus, Herz- und Kreislaufzentrum Rotenburg a.d.F.
Z Kardiol. 1991 Jan;80(1):15-9.
Seventeen patients with coronary heart disease were included in a double-blind randomized study. They received either 5 mg of carvedilol or 6 mg of propranolol intravenously. Heart rate, aortic pressure, mean coronary sinus pressure and coronary flow (thermodilution) were measured, and coronary resistance and rate-pressure product were calculated before and 15 min after the infusion, which lasted 10 min. Carvedilol lowered significantly (p less than 0.05) heart rate (mean 76 to 69/min), aortic pressure (mean 153/80 to 135/72 mm Hg), rate-pressure product (mean 117 to 93 mm Hg/min) and coronary flow (mean 114 to 94 ml/min). Coronary resistance and coronary flow related to rate-pressure product showed no significant change after carvedilol. Propranolol lowered heart rate (mean 76 to 64/min; p less than 0.05) and rate-pressure product (mean 109 to 96 mm Hg/min; ns). Aortic pressure, coronary flow, coronary resistance, and coronary flow related to rate-pressure product showed no significant change after propranolol. Thus, carvedilol lowered rate-pressure product more markedly than propranolol on account of its acute blood-pressure lowering effect. Neither drug seems to have a direct influence on coronary resistance vessels.
17例冠心病患者被纳入一项双盲随机研究。他们静脉注射5毫克卡维地洛或6毫克普萘洛尔。测量心率、主动脉压、平均冠状窦压力和冠状动脉血流量（热稀释法），并在持续10分钟的输注前及输注后15分钟计算冠状动脉阻力和速率-压力乘积。卡维地洛显著降低（p<0.05）心率（平均从76次/分钟降至69次/分钟）、主动脉压（平均从153/80毫米汞柱降至135/72毫米汞柱）、速率-压力乘积（平均从117毫米汞柱/分钟降至93毫米汞柱/分钟）和冠状动脉血流量（平均从114毫升/分钟降至94毫升/分钟）。卡维地洛治疗后冠状动脉阻力及与速率-压力乘积相关的冠状动脉血流量无显著变化。普萘洛尔降低心率（平均从76次/分钟降至64次/分钟；p<0.05）和速率-压力乘积（平均从109毫米汞柱/分钟降至96毫米汞柱/分钟；无统计学意义）。普萘洛尔治疗后主动脉压、冠状动脉血流量、冠状动脉阻力及与速率-压力乘积相关的冠状动脉血流量无显著变化。因此，由于卡维地洛的急性降压作用，其降低速率-压力乘积比普萘洛尔更显著。两种药物似乎对冠状动脉阻力血管均无直接影响。
