Misra M, Bhandari K, Thakur R, Puri V K
Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
Int J Cardiol. 1989 Apr;23(1):37-41. doi: 10.1016/0167-5273(89)90327-6.
The efficacy of oral atenolol in increasing the capacity and duration of exercise in 43 patients in sinus rhythm with mitral stenosis was evaluated and compared with that of oral verapamil in an open-label cross-over design. It was observed that although oral atenolol (100 mg per day) caused significant reductions in heart rate while resting and during exercise (P less than 0.001), the increases in capacity and duration of exercise were not significant. Oral verapamil (80 mg three times per day) also caused significant reductions in the heart rates at rest and during exercise (P less than 0.05) but the increases observed, although greater than that with atenolol, failed to reach the level of statistical significance. Occasional side effects occurred with both the drugs. Subjective symptoms of dyspnoea at rest and on exertion were relieved with both the drugs. We conclude that, although both drugs reduce the symptoms of dyspnoea, they cause only minor increases in the objective parameters. They do not, therefore, provide an alternative to surgery and have only a temporary place in the management of patients in sinus rhythm with mitral stenosis who are awaiting surgery.
采用开放标签交叉设计，对43例窦性心律伴二尖瓣狭窄患者口服阿替洛尔增加运动能力和持续时间的疗效进行了评估，并与口服维拉帕米的疗效进行了比较。结果观察到，尽管口服阿替洛尔（每日100毫克）可使静息和运动时的心率显著降低（P<0.001），但运动能力和持续时间的增加并不显著。口服维拉帕米（每日3次，每次80毫克）也可使静息和运动时的心率显著降低（P<0.05），尽管观察到的增加幅度大于阿替洛尔，但未达到统计学显著水平。两种药物均偶有副作用。两种药物均可缓解静息和运动时的主观呼吸困难症状。我们得出结论，尽管两种药物均可减轻呼吸困难症状，但仅使客观参数略有增加。因此，它们不能替代手术，对于等待手术的窦性心律伴二尖瓣狭窄患者，在治疗中仅具有临时作用。
