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西洛他唑急性心肌梗死后变时性效应的影响:来自左心室容积和功能变化的见解

Impact of chronotropic effect of cilostazol after acute myocardial infarction: insights from change in left ventricular volume and function.

作者信息

Lee Sang Hak, Choi Seung-Hyuk, Choi Seonghoon, Jung Jae-Hun, Lee Namho, Choi Young-Jin, Park Dae-Gyun, Hong Kyung-Soon, Han Kyoo-Rok, Oh Dong-Jin, Rhim Chong-Yun

机构信息

Cardiology Division, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.

出版信息

Circ J. 2007 Jan;71(1):106-11. doi: 10.1253/circj.71.106.

Abstract

BACKGROUND

Cilostazol, a phosphodiesterase inhibitor, is an antiplatelet agent with positive chronotropic effect, the impact of which on left ventricular (LV) volume and function in acute myocardial infarction (AMI) was evaluated in the present study.

METHODS AND RESULTS

In 56 patients with AMI treated with primary coronary stenting, serial echocardiographic studies within 24 h and at 6 months were performed. Patients received a conventional antiplatelet regimen either without cilostazol (group 1, n=29) or with cilostazol (group 2, n=27). At 6 months, the difference in the change in heart rate between group 1 and group 2 was statistically significant (9.9 beats/min; p=0.04). However, changes in LV end-systolic volume (LVESV) (7.1+/-8.2 vs 10.0+/-21.7 ml, p=0.60), LV ejection fraction (EF) (8.2+/-9.9 vs 9.0+/-12.6%, p=0.85) and the ratio of early mitral inflow velocity to the mitral annular velocity (E/E') (0.6+/-3.7 vs -1.7+/-3.2) were not different between the 2 groups. Cardiac event rate was similar between the 2 groups. On multivariate regression analyses, cilostazol therapy had no significant influence on the changes in LVESV, LVEF or E/E'.

CONCLUSIONS

In this study, the addition of cilostazol on conventional drug therapy had no adverse influence on LV remodeling or LV function after AMI.

摘要

背景

西洛他唑是一种磷酸二酯酶抑制剂,是一种具有正性变时作用的抗血小板药物,本研究评估了其对急性心肌梗死(AMI)患者左心室(LV)容积和功能的影响。

方法与结果

对56例行急诊冠状动脉支架置入术的AMI患者在24小时内及6个月时进行了系列超声心动图检查。患者接受常规抗血小板治疗,其中一组(1组,n = 29)未使用西洛他唑,另一组(2组,n = 27)使用西洛他唑。6个月时,1组和2组心率变化的差异具有统计学意义(9.9次/分钟;p = 0.04)。然而,两组间左心室收缩末期容积(LVESV)的变化(7.1±8.2 vs 10.0±21.7 ml,p = 0.60)、左心室射血分数(EF)(8.2±9.9 vs 9.0±12.6%,p = 0.85)以及二尖瓣血流早期峰值速度与二尖瓣环速度比值(E/E')(0.6±3.7 vs -1.7±3.2)并无差异。两组的心脏事件发生率相似。多因素回归分析显示,西洛他唑治疗对LVESV、LVEF或E/E'的变化无显著影响。

结论

在本研究中,在常规药物治疗基础上加用西洛他唑对AMI后的左心室重构或左心室功能无不良影响。

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