Ito Nobuhisa, Tashiro Tadashi, Morishige Noritsugu, Nishimi Masaru, Hayashida Yoshio, Minematsu Noritoshi, Kuwahara Go, Sukehiro Yuta, Teratani Hiromitsu
Department of Cardiovascular Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
Heart Surg Forum. 2012 Aug;15(4):E189-94. doi: 10.1532/HSF98.20111152.
Landiolol hydrochloride, an ultrashort-acting β1-selective blocker, is a highly regulated drug. This study evaluated the safety and efficacy of this drug for cases of coronary artery bypass grafting (CABG) with left ventricular dysfunction. Between September 2006 and August 2009, 32 patients with a left ventricular ejection fraction of <40% underwent CABG. Two groups of patients, a group administered landiolol hydrochloride and a control group not administered this drug, were compared. The administration of landiolol hydrochloride was initiated at 1 μg/kg per minute (γ) after cardiopulmonary bypass in on-pump cases and after completion of all the distal anastomoses in off-pump cases. We observed no significant differences between the groups with respect to preoperative patient background or incidences of complications, except for postoperative atrial fibrillation. The heart rate decreased significantly 30 minutes after landiolol hydrochloride administration, but no change was observed in arterial pressure. No change was observed in other parameters; the hemodynamics were stable. The occurrence of atrial fibrillation during the intensive care unit stay (during landiolol hydrochloride administration) was significantly lower in the administration group. The difference remained significant after multiple logistic regression analysis; landiolol hydrochloride was the sole inhibitory factor.
盐酸兰地洛尔是一种超短效β1选择性阻滞剂，是一种管控严格的药物。本研究评估了该药物用于左心室功能不全的冠状动脉旁路移植术（CABG）病例的安全性和有效性。在2006年9月至2009年8月期间，32例左心室射血分数<40%的患者接受了CABG。比较了两组患者，一组给予盐酸兰地洛尔，另一组未给予该药物作为对照组。在体外循环心脏停跳病例中，在体外循环后，以及在非体外循环病例中所有远端吻合完成后，以每分钟1μg/kg（γ）开始给予盐酸兰地洛尔。除术后房颤外，两组患者在术前患者背景或并发症发生率方面无显著差异。给予盐酸兰地洛尔30分钟后心率显著下降，但动脉压未见变化。其他参数未见变化；血流动力学稳定。给药组在重症监护病房停留期间（给予盐酸兰地洛尔期间）房颤的发生率显著较低。经过多因素逻辑回归分析后，差异仍然显著；盐酸兰地洛尔是唯一的抑制因素。
