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[扩张型心肌病患者静脉注射匹莫苯丹(UDGG 115 BS)后左心室容积减小及血流动力学改善]

[Reduction in left ventricular volume and improvement in hemodynamics following intravenous administration of pimobendan (UDGG 115 BS) in dilated cardiomyopathy].

作者信息

Permanetter B, Sebening H, Busch U, Lutilsky L

机构信息

I. Medizinische Klinik der Technischen Universität München.

出版信息

Z Kardiol. 1990 Aug;79(8):565-72.

PMID:2220013
Abstract

Acute cardiovascular effects of 5 mg (group I, n = 6) and 10 mg (group II, n = 6) i.v. pimobendan (UDCG 115 BS) were studied by right and left heart catheterizations in patients suffering from idiopathic dilated cardiomyopathy (NYHA II and III). Before and 2.5 h after application of pimobendan left ventricular volumes and left ventricular dP/dtmax were evaluated by left heart catheterization. Right atrial pressure (RAP), pulmonary capillary wedge pressure (PCP), cardiac output (CO), heart rate, and systemic blood pressure were assessed before and 2.5, 4, and 6 h after administration of pimobendan. PCP was reduced from 12.2 +/- 7.5 to 8.3 +/- 7.1 mm Hg (p less than 0.05) by 5 mg of pimobendan, and from 18.3 +/- 6.2 to 6.2 +/- 3.4 mm Hg (p less than 0.005) by 10 mg of pimobendan. Reduction of RAP was significant only in group II (from 6.2 +/- 3.2 to 1.2 +/- 0.9 mm Hg; p less than 0.05). In contrast to other hemodynamic parameters, the significant increase of CO exhibited no dose-dependency. Only 10 mg of pimobendan induced a temporary reduction of mean arterial blood pressure. An increase in heart rate occurred only in group I and was merely transient. Left ventricular end diastolic and end systolic volume indices were clearly reduced by 5 mg as well as by 10 mg of pimobendan. A significant rise of left ventricular ejection fraction occurred only in group II. However, left ventricular dP/dtmax was increased significantly in both groups. No adverse effects were noted during acute administration of pimobendan. Therefore, intravenous pimobendan may be a useful drug in the treatment of acute cardiac failure.

摘要

采用左右心导管插入术,对6例患有特发性扩张型心肌病(纽约心脏协会心功能分级为II级和III级)的患者静脉注射5mg(I组,n = 6)和10mg(II组,n = 6)匹莫苯丹(UDCG 115 BS)后的急性心血管效应进行了研究。在应用匹莫苯丹前以及用药后2.5小时,通过左心导管插入术评估左心室容积和左心室dP/dtmax。在给予匹莫苯丹前以及给药后2.5、4和6小时评估右心房压力(RAP)、肺毛细血管楔压(PCP)、心输出量(CO)、心率和体循环血压。5mg匹莫苯丹可使PCP从12.2±7.5mmHg降至8.3±7.1mmHg(p<0.05),10mg匹莫苯丹可使其从18.3±6.2mmHg降至6.2±3.4mmHg(p<0.005)。RAP的降低仅在II组有显著意义(从6.2±3.2mmHg降至1.2±0.9mmHg;p<0.05)。与其他血流动力学参数不同,CO的显著增加无剂量依赖性。仅10mg匹莫苯丹可导致平均动脉血压暂时降低。心率增加仅发生在I组且只是短暂的。5mg和10mg匹莫苯丹均可使左心室舒张末期和收缩末期容积指数明显降低。左心室射血分数的显著升高仅发生在II组。然而,两组的左心室dP/dtmax均显著增加。在急性给予匹莫苯丹期间未观察到不良反应。因此,静脉注射匹莫苯丹可能是治疗急性心力衰竭的一种有用药物。

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