Bortone A, Chiddo A, Quagliara D, Musci S, Troito G, Lafranceschina C, Gaglione A, Rizzon P
Cattedra di Cardiologia, Università degli Studi, Bari.
Cardiologia. 1990 Jun;35(6):479-84.
Using quantitative coronary arteriography, the luminal area was measured in the proximal, middle and distal third of a normal coronary vessel in basal condition and 15 min after 0.005 mg/Kg ic gallopamil (Group 1); 15 min after ic placebo (Group 2); 15 and 30 min after iv gallopamil at a dose of 0.03 mg/Kg (Group 3A) and 0.05 mg/Kg (Group 3B). A significant (p less than 0.001) vasodilation was observed in all segments in Group 1 and only in distal segment (p less than 0.05) in Group 3B. Neither did the heart rate, systolic blood pressure nor the coronary driving pressure show any changes. In the second section of this study, we analyzed the effects of the drug on coronary blood flow and resistance in 8 patients without clinical and/or objective evidence of coronary artery disease. Using thermodilution technique, the coronary sinus blood flow (CSBF) and coronary resistance (CR) were measured in basal condition and 5, 10, 15 and 30 min after 0.05 mg/Kg iv gallopamil. We observed a significant (p less than 0.001) increase of CSBF after 10 min and a significant decrease of CR after 10 min (p less than 0.001) and 15 min (p less than 0.05). In conclusion, our results suggest that the anti-ischemic effect of gallopamil can be related not only to the reduction of myocardial oxygen requirement, but also to an improvement of coronary blood flow with a decrease in coronary resistance.
采用定量冠状动脉造影术,在基础状态下以及静脉注射0.005mg/Kg加洛帕米后15分钟(第1组),测量正常冠状动脉近端、中段和远端三分之一段的管腔面积;静脉注射安慰剂后15分钟(第2组);静脉注射剂量为0.03mg/Kg(第3A组)和0.05mg/Kg(第3B组)的加洛帕米后15分钟和30分钟。在第1组的所有节段以及第3B组仅在远端节段观察到显著的(p<0.001)血管扩张(p<0.05)。心率、收缩压和冠状动脉驱动压力均未显示任何变化。在本研究的第二部分,我们分析了该药物对8例无冠状动脉疾病临床和/或客观证据患者的冠状动脉血流和阻力的影响。采用热稀释技术,在基础状态下以及静脉注射0.05mg/Kg加洛帕米后5、10、15和30分钟测量冠状窦血流(CSBF)和冠状动脉阻力(CR)。我们观察到10分钟后CSBF显著增加(p<0.001),10分钟后CR显著降低(p<0.001),15分钟后CR显著降低(p<0.05)。总之,我们的结果表明,加洛帕米的抗缺血作用不仅可能与心肌需氧量的降低有关,还可能与冠状动脉血流改善及冠状动脉阻力降低有关。