Myreng Y, Myhre E
Medical Department B, National Hospital, University of Oslo, Norway.
Am Heart J. 1989 Apr;117(4):870-5. doi: 10.1016/0002-8703(89)90625-x.
The effect of verapamil on left ventricular diastolic function in coronary artery disease was assessed by Doppler echocardiography of transmitral flow velocities in 20 patients. At baseline, isovolumic relaxation time was prolonged compared with that in 18 age-matched normal subjects (95 +/- 13 msec versus 74 +/- 12 msec, p less than 0.001), but decreased to 80 +/- 14 msec (p less than 0.001) after treatment. The ratio between early and atrial-induced transmitral velocities (E/A-ratio) at baseline was lower in patients than in normal subjects (1.1 +/- 0.2 versus 1.4 +/- 0.3, p = 0.01), as was the filling fraction of the first third of diastole (43% +/- 5% versus 50% +/- 4%, p less than 0.001). Verapamil treatment increased the E/A-ratio to 1.3 +/- 0.4 (p less than 0.001) and filling fraction to 45% +/- 4% (p = 0.055) because of increased early filling. No change in systolic performance or heart rate was observed. Thus, coronary artery disease was associated with retarded relaxation and impairment of early filling. However, verapamil treatment enhanced relaxation and induced a filling shift toward early diastole, which indicated improved diastolic performance. The changes probably reflected reduced myocardial ischemia.
通过对20例冠心病患者二尖瓣血流速度进行多普勒超声心动图检查，评估维拉帕米对冠心病患者左心室舒张功能的影响。在基线时，与18名年龄匹配的正常受试者相比，等容舒张时间延长（95±13毫秒对74±12毫秒，p<0.001），但治疗后降至80±14毫秒（p<0.001）。患者基线时二尖瓣早期与心房诱导血流速度之比（E/A比值）低于正常受试者（1.1±0.2对1.4±0.3，p=0.01），舒张期前三分之一的充盈分数也是如此（43%±5%对50%±4%，p<0.001）。由于早期充盈增加，维拉帕米治疗使E/A比值增至1.3±0.4（p<0.001），充盈分数增至45%±4%（p=0.055）。未观察到收缩功能或心率的变化。因此，冠心病与舒张延迟和早期充盈受损有关。然而，维拉帕米治疗增强了舒张功能，并使充盈向舒张早期转移，这表明舒张功能得到改善。这些变化可能反映了心肌缺血的减轻。
