Hoshino Y
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Jpn Heart J. 1988 Nov;29(6):771-9. doi: 10.1536/ihj.29.771.
Acute effects of dibutyryl cyclic AMP (DBcAMP) on hemodynamics, renal circulation and plasma catecholamine levels were examined in 8 patients with congestive heart failure, NYHA functional class II or III. Before and during intravenous infusion of dibutyryl cyclic AMP at 0.1 mg/kg/min for 30 min, hemodynamic variables, renal blood flow (RBF) and plasma catecholamine levels were investigated. 1) DBcAMP increased the cardiac index from 2.69 +/- 0.65 to 3.60 +/- 0.84 liter/min/m2 (+ 33.8%, p less than 0.001) and heart rate from 70.9 +/- 14.3 to 84.1 +/- 15.7 bpm (+ 18.6%, p less than 0.001) and decreased mean aortic pressure from 91.8 +/- 11.3 to 82.5 +/- 9.8 mmHg (-10.1%, p less than 0.001), and systemic vascular resistance from 1840 +/- 570 to 1260 +/- 370 dynes-sec-cm-5 (-31.6%, p less than 0.001). 2) RBF increased from 335 +/- 81 to 517 +/- 188 ml/min (+ 54.3%, p less than 0.05) and renal vascular resistance decreased from 2.33 +/- 0.61 to 1.52 +/- 0.68 x 10(4) dynes-sec-cm-5 (-34.5%, p less than 0.001). 3) Plasma norepinephrine levels increased significantly. The results indicate that DBcAMP is useful for the treatment of congestive heart failure because it improves cardiac hemodynamics by afterload reduction and has a strong vasodilating effect on renal vascular beds.
在8例纽约心脏病协会（NYHA）心功能II级或III级的充血性心力衰竭患者中，研究了二丁酰环磷腺苷（DBcAMP）对血流动力学、肾循环和血浆儿茶酚胺水平的急性影响。在以0.1mg/kg/min的速度静脉输注二丁酰环磷腺苷30分钟之前和期间，对血流动力学变量、肾血流量（RBF）和血浆儿茶酚胺水平进行了研究。1）DBcAMP使心脏指数从2.69±0.65升/分钟/平方米增加到3.60±0.84升/分钟/平方米（增加33.8%，p<0.001），心率从70.9±14.3次/分钟增加到84.1±15.7次/分钟（增加18.6%，p<0.001），平均主动脉压从91.8±11.3毫米汞柱降至82.5±9.8毫米汞柱（降低10.1%，p<0.001），全身血管阻力从1840±570达因·秒·厘米⁻⁵降至1260±370达因·秒·厘米⁻⁵（降低31.6%，p<0.001）。2）肾血流量从335±81毫升/分钟增加到517±188毫升/分钟（增加54.3%，p<0.05），肾血管阻力从2.33±0.61×10⁴达因·秒·厘米⁻⁵降至1.52±0.68×10⁴达因·秒·厘米⁻⁵（降低34.5%，p<0.001）。3）血浆去甲肾上腺素水平显著升高。结果表明，DBcAMP可用于治疗充血性心力衰竭，因为它通过降低后负荷改善心脏血流动力学，并且对肾血管床有强大的血管舒张作用。
