Pouleur H, Hanet C, Schröder E, Col J, Van Mechelen H, Etienne J, Rousseau M F
Department of Physiology, University of Louvain, Brussels, Belgium.
J Cardiovasc Pharmacol. 1989;14 Suppl 2:S18-22.
The purpose of this study was to examine the time course of the changes in left ventricular inotropic state after intravenous pimobendan administration. In conscious dogs, cumulative doses of 1 and 2.5 mg of pimobendan significantly increased heart rate and the isovolumic indices of inotropic state and relaxation. The maximal effect, however, required 2 h to be present. The changes in cardiac index and capillary wedge pressure after the intravenous administration of 5 mg to patients with heart failure confirmed this slightly delayed action of pimobendan. Accordingly, the effects of pimobendan on left ventricular inotropic state in patients with moderate to severe heart failure were determined during cardiac catheterization 130-150 min after injection of 5 (n = 3) or 2.5 (n = 4) mg. After drug administration, heart rate increased slightly (+7 beats/min; NS) while left ventricular end-diastolic and systolic pressure both decreased significantly (from 22.7 to 9.2 mm Hg, p less than 0.007 and from 123 to 90 mm Hg, p less than 0.025, respectively). The isovolumic index of contractility (dP/dt)/DP40 increased by 19.6 +/- 14.7% (p less than 0.02) and the slope of the late systolic stress-volume relationship improved by 48% (p less than 0.05). It is concluded that pimobendan is a positive inotropic agent in the failing human heart as well as a powerful veno- and arteriodilator.
本研究的目的是检测静脉注射匹莫苯丹后左心室变力状态的变化时间过程。在清醒犬中，累积剂量为1和2.5 mg的匹莫苯丹显著增加心率以及变力状态和舒张的等容指数。然而，最大效应需要2小时才会出现。对心力衰竭患者静脉注射5 mg后心脏指数和毛细血管楔压的变化证实了匹莫苯丹这种稍有延迟的作用。因此，在注射5 mg（n = 3）或2.5 mg（n = 4）后130 - 150分钟进行心导管检查时，测定了匹莫苯丹对中重度心力衰竭患者左心室变力状态的影响。给药后，心率略有增加（+7次/分钟；无统计学意义），而左心室舒张末期和收缩期压力均显著降低（分别从22.7降至9.2 mmHg，p < 0.007；从123降至90 mmHg，p < 0.025）。收缩性等容指数（dP/dt）/DP40增加了19.6±14.7%（p < 0.02），晚期收缩期应力 - 容积关系的斜率改善了48%（p < 0.05）。结论是，匹莫苯丹在衰竭的人体心脏中是一种正性肌力药物，也是一种强效的静脉和动脉扩张剂。
