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维拉帕米和美托洛尔对冠心病患者心率变异性的影响

[Effects of Verapamil and Metoprolol on heart rate variability in patients with coronary heart disease].

作者信息

Zhang Qian, Lu Xi Ning, Sun Ning Ling

机构信息

Heart center of Peking University People's Hospital, Beijing 100044, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2007 Dec 18;39(6):610-3.

Abstract

OBJECTIVE

To evaluate the effects of Verapamil and Metoprolol on improving heart rate variability(HRV) in patients with coronary heart disease (CHD).

METHODS

A total of 60 patients, who were diagnosed as CHD according to the results of coronary angiography, were enrolled. All patients were randomly divided into Verapamil group (n=30) and Metoprolol group (n=30). The patients in Verapamil group received Verapamil (480 mg/d) and the patients in Metoprolol group received Metoprolol (50 mg/d) for eight weeks. Office blood pressure, HRV, symptoms of angina Holter recording heart rates per minute and HRV for eight weeks were observed before and after treatment in both groups.

RESULTS

Both office blood pressures and the numbers of attacks of angina pectoris and symptoms all decreased obviously in the two groups after treatment. Blood pressures were reduced from 137.12/84.36 mm Hg to 131.80/77.68 mm Hg in Metoprolol group, and also reduced from 137.72/83.92 mm Hg to 129.56/78.76 mm Hg in Verapamil group (P>0.05, compared between the two groups). In both the Verapamil and Metoprolol groups, heart rates decreased, SDNN (standard deviation of all normal to normal RR intervals) and HRVTI (HRV indexes of time-domain) both increased significantly after treatment (P>0.05). And HRV indexes of low-frequency(LF), high-frequency (HF) and total power (TP) were increased obviously, while the low-to high-frequency ratio (LF/HF), very-low-frequency (VLF) were remarkably lower(P<0.05). Compared with Verapamil group, the changes of frequency-domain indexes in Metoprolol group were significant(P<0.05).

CONCLUSION

In patients with CHD, both Metoprolol and Verapamil can increase the HRV.

摘要

目的

评估维拉帕米和美托洛尔对改善冠心病(CHD)患者心率变异性(HRV)的效果。

方法

纳入60例根据冠状动脉造影结果确诊为CHD的患者。所有患者随机分为维拉帕米组(n = 30)和美托洛尔组(n = 30)。维拉帕米组患者接受维拉帕米(480毫克/天)治疗,美托洛尔组患者接受美托洛尔(50毫克/天)治疗,为期8周。观察两组患者治疗前后的诊室血压、HRV、心绞痛症状、动态心电图记录的每分钟心率以及8周的HRV。

结果

两组治疗后诊室血压、心绞痛发作次数及症状均明显降低。美托洛尔组血压从137.12/84.36毫米汞柱降至131.80/77.68毫米汞柱,维拉帕米组血压从137.72/83.92毫米汞柱降至129.56/78.76毫米汞柱(两组比较,P>0.05)。维拉帕米组和美托洛尔组治疗后心率均下降,SDNN(全部正常RR间期的标准差)和HRVTI(时域HRV指标)均显著升高(P>0.05)。低频(LF)、高频(HF)和总功率(TP)的HRV指标明显升高,而低频与高频比值(LF/HF)、极低频(VLF)明显降低(P<0.05)。与维拉帕米组相比,美托洛尔组频域指标变化显著(P<0.05)。

结论

在冠心病患者中,美托洛尔和维拉帕米均可增加HRV。

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