Borisova E V, Afanasyev S A, Rebrova T Yu, Kisteneva I V, Batalov R E, Popov S V
Research Institute of Cardiology, Siberian Branch, Russian Academy of Medical Sciences, Tomsk, Russia.
Ter Arkh. 2016;88(1):35-39. doi: 10.17116/terarkh201688135-39.
To evaluate the efficacy of sotalol depending on the magnitude of changes in adrenal responsiveness and autonomic nervous system tone in patients with paroxysmal atrial fibrillation (AF).
Twenty-six patients with paroxysmal AF in the presence of coronary heart disease (CHD) and hypertension were examined. Sinus rhythm variability and sympathicotonic and vagotonic disorders were studied in patients with paroxysmal AF before and during sotalol treatment. A commercial Beta-ARM-Agat kit was used to estimate the adrenal responsiveness of erythrocyte membranes (β-APM), which can judge the body's individual sensitivity to β-adrenoblockers.
Sotalol used in the average therapeutic doses of 160-240 mg did not reduce ejection fraction or increase atrioventricular conduction up to abnormal values. In patients with borderline and mild hypertension, the drug lowered blood pressure statistically significantly (p=0.01) and was well tolerated. The drug increased the sensitivity of β-adrenoblockers in patients with adrenergic AF.
The effect of sotalol on the autonomic nervous system manifested in the higher power of a high-frequency spectral component of heart rate variability than in that of a low-frequency one. Long-term sotalol administration significantly reduced β-APM, increasing the sensitivity of adrenoceptors.
根据阵发性心房颤动（AF）患者肾上腺反应性和自主神经系统张力的变化幅度评估索他洛尔的疗效。
对26例患有冠心病（CHD）和高血压的阵发性AF患者进行检查。研究了阵发性AF患者在索他洛尔治疗前和治疗期间的窦性心律变异性以及交感神经亢进和迷走神经亢进紊乱情况。使用商业Beta-ARM-Agat试剂盒评估红细胞膜的肾上腺反应性（β-APM），其可判断机体对β-肾上腺素能阻滞剂的个体敏感性。
平均治疗剂量为160 - 240 mg的索他洛尔不会降低射血分数或使房室传导增加至异常值。在临界高血压和轻度高血压患者中，该药物使血压有统计学意义地降低（p = 0.01），且耐受性良好。该药物增加了肾上腺素能性AF患者对β-肾上腺素能阻滞剂的敏感性。
索他洛尔对自主神经系统的作用表现为心率变异性高频谱成分的功率高于低频谱成分。长期服用索他洛尔可显著降低β-APM，增加肾上腺素能受体的敏感性。
