Seguro C, Sau F, Cherchi A
Istituto di Cardiologia, Università degli Studi, Cagliari.
Cardiologia. 1991 Jan;36(1):39-45.
The influence of cardioselectivity and/or intrinsic sympathomimetic activity (ISA) of betablockers on hemodynamic antihypertensive effect and on left ventricular (LV) dimensions and function was studied by echocardiography in 72 hypertensive patients, mean age 43 years. After 15 days of placebo, active therapy was given for 1 month: acebutolol (ACEB, n: 16, 400-800 mg/day), atenolol (ATEN, n: 16, 50-100 mg/day), pindolol (PIND, n: 13, 15-30 mg/day), timolol (TIMO, n: 15, 10-20 mg/day) and nadolol (NADO, n: 12, 80-160 mg/day). All betablockers showed effective antihypertensive activity. Betablockers without ISA (ATEN, TIMO, NADO) reduced cardiac output (p less than 0.05), those with ISA (ACEB, PIND) decreased total peripheral resistance (p less than 0.01 and p less than 0.05 respectively). Independently from ISA, cardioselective betablockers (ATEN, ACEB) increased LV end diastolic dimension and stroke volume (p less than 0.05). LV mass was not changed, although interventricular septum thickness decreased after TIMO and NADO (p less than 0.05). LV function, as assessed by fractional shortening, was not impaired by any betablocker.
通过超声心动图研究了β受体阻滞剂的心脏选择性和/或内在拟交感活性(ISA)对72例平均年龄43岁的高血压患者血流动力学降压效果以及左心室(LV)大小和功能的影响。在服用15天安慰剂后,给予1个月的积极治疗:醋丁洛尔(ACEB,n = 16,400 - 800毫克/天)、阿替洛尔(ATEN,n = 16,50 - 100毫克/天)、吲哚洛尔(PIND,n = 13,15 - 30毫克/天)、噻吗洛尔(TIMO,n = 15,10 - 20毫克/天)和纳多洛尔(NADO,n = 12,80 - 160毫克/天)。所有β受体阻滞剂均显示出有效的降压活性。无ISA的β受体阻滞剂(ATEN、TIMO、NADO)降低心输出量(p < 0.05),有ISA的(ACEB、PIND)分别降低总外周阻力(p < 0.01和p < 0.05)。与ISA无关,心脏选择性β受体阻滞剂(ATEN、ACEB)增加左室舒张末期内径和每搏输出量(p < 0.05)。左室质量未改变,尽管TIMO和NADO治疗后室间隔厚度降低(p < 0.05)。通过缩短分数评估的左室功能未受到任何β受体阻滞剂的损害。