Kober G, Kästner R, Hopf R, Kaltenbach M
Z Kardiol. 1986 Jul;75(7):386-93.
In a randomized double blind placebo-controlled study in 20 patients the influence of the calcium antagonist diltiazem (1.0 mg administered intracoronarily, distal from the stenosis) on the severity of myocardial ischemia during therapeutic coronary occlusion (transluminal coronary angioplasty) of the left anterior descending coronary artery was investigated. The severity and time of onset of ischemic ST and T wave changes as well as anginal pain were significantly reduced 3 and 8 minutes after diltiazem, whereas there was no definite change in the controls. Heart rate and blood pressure were not influenced by diltiazem or placebo. The results indicate a direct antiischemic effect of diltiazem on myocardial cells. The findings can neither be explained by an influence on cardiac afterload nor by coronary vessel reactions, nor a reduction of myocardial contractility. The findings do not permit conclusions in terms of the duration of this direct antiischemic mode of action.
在一项针对20名患者的随机双盲安慰剂对照研究中，研究了钙拮抗剂地尔硫䓬（冠状动脉内给药1.0毫克，在狭窄远端）对左前降支冠状动脉治疗性闭塞（经皮冠状动脉腔内血管成形术）期间心肌缺血严重程度的影响。地尔硫䓬给药3分钟和8分钟后，缺血性ST段和T波改变以及心绞痛的严重程度和发作时间显著降低，而对照组无明显变化。心率和血压不受地尔硫䓬或安慰剂的影响。结果表明地尔硫䓬对心肌细胞有直接的抗缺血作用。这些发现既不能通过对心脏后负荷的影响来解释，也不能通过冠状血管反应或心肌收缩力的降低来解释。这些发现不允许就这种直接抗缺血作用方式的持续时间得出结论。
