Kanorskii S G, Sereda A F
Kuban State Medical University, Krasnodar, Russia.
Kardiologiia. 2016 Dec;56(12):27-32.
to compare efficacy of verapamil and amlodipine in treatment of chronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction (EF) in patients with hypertensive disease (HD).
Patients with stage III HD, class II-III CHF, and LVEF more or equal 50% (n=167, age 48-70 years) underwent complex examination before and after 12 months of treatment with perindopril combined either with verapamil SR (n=85) or amlodipine (n=82).
Average 6-minute walk distance increased after both verapamil and amlodipine containing treatment (by 15.1 and 18.2%, respectively). Administration of both drugs was associated with improvement of clinical state and quality of life. But only treatment containing amlodipine was associated with lowering of N-terminal probrain natriuretic peptide and improvement of echocardiographic parameters of LV diastolic function.
In treatment of CHF in patients with HD amlodipine is at least not inferior to verapamil for elevation of exercise tolerance and superior to verapamil for improvement of LV diastolic function. Amlodipine might be perspective for use in patients with chronotropic incompetence.
比较维拉帕米和氨氯地平治疗高血压病（HD）患者左心室（LV）射血分数（EF）保留的慢性心力衰竭（CHF）的疗效。
III期HD、II-III级CHF且左室射血分数≥50%的患者（n=167，年龄48-70岁）在培哚普利联合维拉帕米缓释片（n=85）或氨氯地平（n=82）治疗12个月前后进行了综合检查。
含维拉帕米和氨氯地平的治疗后6分钟步行平均距离均增加（分别增加15.1%和18.2%）。两种药物的使用均与临床状态和生活质量的改善相关。但只有含氨氯地平的治疗与N末端脑钠肽前体降低及左室舒张功能超声心动图参数改善相关。
在HD患者CHF的治疗中，氨氯地平在提高运动耐量方面至少不劣于维拉帕米，在改善左室舒张功能方面优于维拉帕米。氨氯地平可能对心率变时性功能不全患者的使用具有前景。
