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E-1020与多巴胺对麻醉犬急性二尖瓣反流血流动力学疗效的比较

Hemodynamic efficacy of E-1020 in comparison with dopamine on acute mitral regurgitation in anesthetized dogs.

作者信息

Tanio H, Kumada T, Hayashi M, Himura Y, Nakamura Y, Kawai C

机构信息

Department of Internal Medicine, Faculty of Medicine, Kyoto University, Japan.

出版信息

Jpn Circ J. 1991 Nov;55(11):1068-76. doi: 10.1253/jcj.55.1068.

Abstract

To evaluate the effects of a new phosphodiesterase inhibitor, E-1020 (1, 2-dihydro-6-methyl-2-oxo-5-(imidazo [1, 2-a] pyridin-6-yl)-3-pyridine carbonitrile hydrochloride monohydrate), on cardiovascular hemodynamics in acute heart failure, we compared its effects with those of dopamine on experimentally produced acute mitral regurgitation in dogs. After the production of mitral regurgitation by transmyocardial chordal sectioning and obtaining a stable state, dopamine (5 micrograms/kg/min) was infused until the peak positive dP/dt (peak (+) dP/dt) increased to about 50% of the predopamine value. After complete recovery, E-1020 (30 micrograms/kg) was infused over 5 min and the data were obtained 10 min later. Both drugs equally increased peak (+) dP/dt, decreased systemic vascular resistance, and increased cardiac output. Left ventricular (LV) end-diastolic pressure, LV end-diastolic segment length (EDL), and mean left atrial (LA) pressure decreased with both drugs. The changes in EDL and mean LA pressure were larger with E-1020 than with dopamine (p less than .01 and p less than .05). Although mean inferior vena caval blood flow volume (mIVCF) increased and mean inferior vena caval pressure decreased with both drugs, the increment of mIVCF was smaller with E-1020 (p less than .001). Thus, E-1020 had not only a positive inotropic effect but also a vasodilatory action both on resistance vessels and on capacitance vessels.

摘要

为评估新型磷酸二酯酶抑制剂E-1020(1,2-二氢-6-甲基-2-氧代-5-(咪唑并[1,2-a]吡啶-6-基)-3-吡啶甲腈盐酸盐一水合物)对急性心力衰竭心血管血流动力学的影响,我们将其与多巴胺对实验性犬急性二尖瓣反流的影响进行了比较。通过经心肌切断腱索制造二尖瓣反流并达到稳定状态后,输注多巴胺(5微克/千克/分钟),直至最大正向dP/dt(最大(+)dP/dt)增加至多巴胺给药前值的约50%。完全恢复后,在5分钟内输注E-1020(30微克/千克),并在10分钟后获取数据。两种药物均能同等程度地增加最大(+)dP/dt、降低全身血管阻力并增加心输出量。左心室(LV)舒张末期压力、LV舒张末期节段长度(EDL)和平均左心房(LA)压力在两种药物作用下均降低。E-1020引起的EDL和平均LA压力变化比多巴胺更大(p<0.01和p<0.05)。虽然两种药物均使平均下腔静脉血流量(mIVCF)增加且平均下腔静脉压力降低,但E-1020引起的mIVCF增加幅度较小(p<0.001)。因此,E-1020不仅具有正性肌力作用,而且对阻力血管和容量血管均有血管舒张作用。

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