Shioto T, Takenaka K, Sakamoto T, Amano K, Suzuki J, Amano W, Takahashi H, Sugimoto T
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
J Cardiol Suppl. 1989;21:65-72, discussion 73-4.
To investigate the origin and evaluate the effect of one of the most potent beta blocker, carteolol, on premature ventricular contractions (PVCs) in patients with mitral valve prolapse (MVP), 21 patients (35 +/- 12 years; mean +/- SD) including 10 with PVCs were studied by simultaneous electrocardiography and echocardiography before and after intravenous injection of carteolol. In all 21 MVP patients including 10 MVP patients with PVCs, carteolol (6 micrograms/kg/2 min, i.v.) caused significant decrease in systolic and diastolic blood pressures and in heart rate. Carteolol markedly (25% or more) reduced frequency of PVCs in four of the 10 patients, but no significant changes in five, and PVCs were increased in frequency in the remaining one. However, in all 21 MVP patients, carteolol did not change left ventricular end-diastolic and end-systolic dimensions, and the degree of MVP nor mitral regurgitant areas evaluated by color Doppler echocardiography. These results were exactly the same as those of the patients with PVCs. In conclusion, intravenous injection of beta-blocker, carteolol, reduced PVCs in 40% of the MVP patients with PVCs, but this antiarrhythmic action is not related to the degree of mitral valve prolapse, or mitral regurgitation evaluated by Doppler method.
为了研究最有效的β受体阻滞剂之一卡替洛尔的来源并评估其对二尖瓣脱垂(MVP)患者室性早搏(PVCs)的影响,我们对21例患者(年龄35±12岁;均值±标准差)进行了研究,其中10例有PVCs,在静脉注射卡替洛尔前后,通过同步心电图和超声心动图进行观察。在所有21例MVP患者(包括10例有PVCs的MVP患者)中,卡替洛尔(6微克/千克/2分钟,静脉注射)导致收缩压、舒张压和心率显著下降。卡替洛尔使10例患者中的4例PVCs频率显著降低(降低25%或更多),5例无显著变化,其余1例PVCs频率增加。然而,在所有21例MVP患者中,卡替洛尔并未改变左心室舒张末期和收缩末期内径、MVP程度以及通过彩色多普勒超声心动图评估的二尖瓣反流面积。这些结果与有PVCs的患者完全相同。总之,静脉注射β受体阻滞剂卡替洛尔可使40%有PVCs的MVP患者的PVCs减少,但这种抗心律失常作用与二尖瓣脱垂程度或通过多普勒方法评估的二尖瓣反流无关。