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[选择性和非选择性肾上腺素能β受体阻滞剂对人体心脏特定电生理特性的影响]

[Effect of selective and non-selective adrenergic beta receptor blockaders on selected electrophysiologic properties of the human heart].

作者信息

Ciemniewski Z, Trusz-Gluza M, Swiderska E, Grzegorzewski B, Giec L

出版信息

Kardiol Pol. 1989;32(6):342-6.

PMID:2561167
Abstract

Beta-2 adrenergic receptors were found in a human heart and their role in regulation of inotropic properties during last year was proved. The aim of our study was comparison of effects of selective (metoprolol) and nonselective (propranolol) beta-receptors blockade on cardiac electrophysiological properties. The study was carried out in 20 patients in the majority without organic heart injury and clinical symptoms of the sinus node dysfunction as well as atroioventricular conduction disorders. Method of the transoesophageal left atrial stimulation was utilized. Examinations were performed after drugs administrations in the same persons, during following days. Propranolol and metoprolol were intravenously administrated in a dose of 0.2 mg/kg b.w. Both drugs statistically significant lengthened sinus rhythm cycle time, sinus node recovery time, sinus node and a-v node effective refraction and lowered Wenckebach's point. They did not significantly effect on sinoatrial conduction and the atrial effective refraction. There were no significant differences between examined beta-blockers. Obtained results allowed us to conclude that: 1) eletrophysiologic properties of propranolol and metoprolol are similar, 2) it seems that in physiological conditions the effects of the adrenergic nervous system on electrophysiologic properties of sinus node, atrio-ventricular node and atrium is mainly realized by beta-1 adrenergic receptors.

摘要

去年在人心脏中发现了β-2肾上腺素能受体,并证实了其在调节心肌收缩性能中的作用。我们研究的目的是比较选择性(美托洛尔)和非选择性(普萘洛尔)β受体阻滞剂对心脏电生理特性的影响。该研究在20名患者中进行,这些患者大多没有器质性心脏损伤以及窦房结功能障碍和房室传导障碍的临床症状。采用经食管左心房刺激法。在随后几天内,对同一批人给药后进行检查。普萘洛尔和美托洛尔均以0.2mg/kg体重的剂量静脉给药。两种药物均在统计学上显著延长了窦性心律周期时间、窦房结恢复时间、窦房结和房室结有效不应期,并降低了文氏点。它们对窦房传导和心房有效不应期没有显著影响。所检查的β受体阻滞剂之间没有显著差异。获得的结果使我们能够得出以下结论:1)普萘洛尔和美托洛尔的电生理特性相似;2)在生理条件下,肾上腺素能神经系统对窦房结、房室结和心房电生理特性的影响似乎主要通过β-1肾上腺素能受体实现。

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