Taniguchi H, Iwasaka T, Sugiura T, Takayama Y, Sumimoto T, Onoyama H, Takashima H, Nakamura S, Inada M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Arzneimittelforschung. 1990 Apr;40(4):428-31.
To determine the effects of ibopamine on hemodynamic parameters, 9 patients with cardiac dilation after acute myocardial infarction were studied. Although there were no significant changes in mean blood pressure, heart rate and rate pressure product after administration of ibopamine, cardiac index and urine volume increased significantly. These data indicate that ibopamine exerts a positive inotropic effect on the myocardium and vasodilating effect on renal vasculature without increasing myocardial oxygen consumption. However, pulmonary capillary wedge pressure increased significantly at 30 min after ibopamine and decreased to the control value at 120 min. A significant increase in heart rate was observed in 3 patients which was followed by chest pain. In addition to increase in cardiac contractile force and decrease in subendocardial perfusion from elevated left ventricular end diastolic pressure, increase in heart rate would decrease diastole time, while increase in oxygen consumption results in aggravation of ischemia especially in patients with multivessel coronary disease. From these findings it is considered that ibopamine should be administered with care to patients with multivessel coronary disease.
为确定异波帕胺对血流动力学参数的影响，对9例急性心肌梗死后心脏扩大的患者进行了研究。给予异波帕胺后，平均血压、心率和心率血压乘积虽无显著变化，但心脏指数和尿量显著增加。这些数据表明，异波帕胺对心肌有正性肌力作用，对肾血管有血管舒张作用，且不增加心肌耗氧量。然而，异波帕胺给药后30分钟肺毛细血管楔压显著升高，120分钟时降至对照值。3例患者心率显著增加，随后出现胸痛。除了心脏收缩力增加以及左心室舒张末期压力升高导致心内膜下灌注减少外，心率增加会缩短舒张期时间，而耗氧量增加会导致缺血加重，尤其是在多支冠状动脉疾病患者中。从这些发现来看，对于多支冠状动脉疾病患者，应用异波帕胺时应谨慎。
