Meluzín J, Nechvátal L, Groch L, Spinarová L, Novák M
I. interní klinika fakultní nemocnice s poliklinikou UNZ, Brno.
Cas Lek Cesk. 1991 Mar 22;130(12):358-60.
In a double blind crossover five-week trial with a randomized onset in 12 patients with normal blood pressure, stable angina pectoris and more severe left ventricular dysfunction (ejection fraction less than or equal to 40%) the effect of placebo nifedipine and diltiazem on left ventricular function and tolerance of exercise was compared. The investigation was done by means of echocardiography after a load with stimulation of the heart by an oesophageal electrode. As compared with placebo, only diltiazem retarded significantly the period before development of stenocardia on stimulation of the heart. There was no significant difference between nifedipine and diltiazem as regards the effect exerted on the ejection fraction and time which elapsed after stimulation before stenocardia developed. The authors observed an unequal response of patients to the administration of nifedipine and diltiazem (some patients had less favourable findings, although they were not subjectively aware of this deterioration). Therefore these drugs must be administered to patients with angina pectoris and more severe left ventricular dysfunction with care and only if other drugs (nitrates or angiotensin convertase inhibitors) do not eliminate ischaemia and pain.
在一项针对12名血压正常、患有稳定型心绞痛且左心室功能更严重受损（射血分数小于或等于40%）的患者进行的双盲交叉五周试验中，随机分组后开始试验，比较了安慰剂、硝苯地平和地尔硫䓬对左心室功能和运动耐受性的影响。该研究通过食管电极刺激心脏负荷后进行超声心动图检查来完成。与安慰剂相比，只有地尔硫䓬能显著延迟刺激心脏后心绞痛发作前的时间。硝苯地平和地尔硫䓬在对射血分数的影响以及刺激后至心绞痛发作所经过的时间方面没有显著差异。作者观察到患者对硝苯地平和地尔硫䓬的给药反应不同（一些患者的结果较差，尽管他们主观上并未意识到这种恶化）。因此，对于心绞痛和左心室功能更严重受损的患者，必须谨慎使用这些药物，并且只有在其他药物（硝酸盐或血管紧张素转换酶抑制剂）无法消除缺血和疼痛时才使用。
