Sinn R, Wolf R
Abteilung Kardiologie I, Herz-Kreislauf-Klinik, Bevensen.
Z Kardiol. 1989;78 Suppl 5:83-8.
In a randomized, double-blind, placebocontrolled study 40 patients with exercise-induced ischemic ST depression were given 75 mg gallopamil in slow release form twice daily. The study had 2 periods. After a 3 day run-in-period and a 14 day open therapy period exercise stress-tests were performed on a bicycle ergometer. 5 patients were dropped from this study. 25 of the remaining 35 patients were "responder" defined as a greater than 30% reduction of the ischemic St depression by gallopamil. These patients were randomly assigned to gallopamil or placebo. At the end of the first open period gallopamil significantly reduced the mean ischemic ST depression by 47% from 0.15 to 0.8 mV (p less than 0.0005). Compared with placebo control, the decrease of the ST depression remained unchanged during gallopamil (0.7 mV). In contrast a statistically significant increase of the ischemic St reaction was observed during placebo. Gallopamil significantly improved exercise tolerance. No side effects or adverse reactions were observed. This study demonstrates that gallopamil slow release is a potent calcium-antagonist in reducing exerciseinduced myocardial ischemia and improving stress tolerance.
在一项随机、双盲、安慰剂对照研究中，40例运动诱发缺血性ST段压低的患者每日两次服用75毫克缓释维拉帕米。该研究有两个阶段。经过3天的导入期和14天的开放治疗期后，在自行车测力计上进行运动应激试验。5例患者退出该研究。其余35例患者中有25例为“反应者”，定义为维拉帕米使缺血性ST段压低降低超过30%。这些患者被随机分配接受维拉帕米或安慰剂治疗。在第一个开放期结束时，维拉帕米使平均缺血性ST段压低从0.15毫伏显著降低47%至0.08毫伏（p<0.0005）。与安慰剂对照相比，维拉帕米治疗期间ST段压低的降低保持不变（0.7毫伏）。相反，在安慰剂治疗期间观察到缺血性ST段反应有统计学意义的增加。维拉帕米显著提高了运动耐量。未观察到副作用或不良反应。本研究表明，缓释维拉帕米是一种有效的钙拮抗剂，可减少运动诱发的心肌缺血并提高应激耐量。
