α和β肾上腺素能受体阻滞剂对血流储备分数和微血管阻力指数的影响。
Impact of alpha- and beta-adrenergic receptor blockers on fractional flow reserve and index of microvascular resistance.
作者信息
Barbato Emanuele, Sarno Giovanna, Berza Catalina Trana, Di Gioia Giuseppe, Bartunek Jozef, Vanderheyden Marc, Di Serafino Luigi, Wijns William, Trimarco Bruno, De Bruyne Bernard
机构信息
Cardiovascular Center Aalst, OLV Clinic, Moorselbaan, 164, B-9300, Aalst, Belgium,
出版信息
J Cardiovasc Transl Res. 2014 Dec;7(9):803-9. doi: 10.1007/s12265-014-9599-8. Epub 2014 Nov 1.
We investigated the effect of β- and α-adrenergic blockers on fractional flow reserve (FFR) and index of microvascular resistance (IMR). In 43 patients (pts) with intermediate stenoses, we measured FFR and IMR before and after nonselective β-blocker propranolol (30 μg/kg, n = 20) and selective β1-blocker metoprolol (40 μg/kg, n = 23) IC; (b) In additional 21 pts after percutaneous coronary intervention (PCI), FFR and IMR were measured before and after α-blocker phentolamine (3 mg) IC. Neither propranolol nor metoprolol changed values of FFR and IMR. Phentolamine slightly decreased FFR (from 0.88 ± 0.05 to 0.87 ± 0.06, p = 0.025) but did not change IMR. FFR decreased from >0.80 to ≤0.80 in 3 pts (14%), but in none, the value decreased to <0.75. β-blockers do not affect FFR and IMR in intermediate stenoses. After PCI, a mild decrease in FFR occurs after α-blockers, though of limited clinical impact.
我们研究了β-肾上腺素能阻滞剂和α-肾上腺素能阻滞剂对血流储备分数（FFR）和微血管阻力指数（IMR）的影响。在43例存在中度狭窄的患者中，我们在非选择性β-阻滞剂普萘洛尔（30μg/kg，n = 20）和选择性β1-阻滞剂美托洛尔（40μg/kg，n = 23）冠状动脉内注射前后测量FFR和IMR；（b）在另外21例经皮冠状动脉介入治疗（PCI）后的患者中，在α-阻滞剂酚妥拉明（3mg）冠状动脉内注射前后测量FFR和IMR。普萘洛尔和美托洛尔均未改变FFR和IMR的值。酚妥拉明使FFR略有降低（从0.88±0.05降至0.87±0.06，p = 0.025），但未改变IMR。3例患者（14%）的FFR从>0.80降至≤0.80，但无一例降至<0.75。β-阻滞剂在中度狭窄时不影响FFR和IMR。PCI后，α-阻滞剂可使FFR轻度降低，尽管临床影响有限。
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