Frais M A, Silke B, Verma S P, Sharma S K, Reynolds G, Jackson N C, Taylor S H
Herz. 1986 Dec;11(6):351-8.
The haemodynamic dose-response effects of a new long-acting slow-calcium channel blocking agent, amlodipine were evaluated in 20 patients with angiographically confirmed coronary heart disease. At rest, following a control saline period, four i.v. doses of the drug (cumulative dosage 1.25, 2.5, 5 and 10 mg) were administered to ten patients and haemodynamics determined in the ten to 15 minutes following injection. Effects on circulatory parameters were only evident following the maximum cumulative dosage. Accordingly in a further ten patients, the regimen was doubled (cumulative i.v. dosage 2.5, 5, 10 and 20 mg). In each study the haemodynamic effects during constant load supine bicycle exercise were evaluated by comparison of values during the control exercise period and following the final cumulative dosage. On the higher regimen, amlodipine significantly reduced resting systolic, diastolic and mean (p less than 0.01) systemic arterial pressure and systemic vascular resistance index (p less than 0.01). Heart rate (p less than 0.01), stroke volume index (p less than 0.01) and cardiac index (p less than 0.01) increased; pulmonary artery occluded pressure was unchanged. During constant load bicycle exercise, the mean arterial pressure was significantly reduced (p less than 0.01), and the heart rate and cardiac index increased (p less than 0.01). Thus the immediate impact of amlodipine in stable coronary artery disease was to reduce left ventricular afterload and augment cardiac pumping performance. The minimum effective i.v. dosage appeared to be 10 mg. Amlodipine appears sufficiently promising to warrant longer-term studies in ischaemic heart disease.
对20例经血管造影证实患有冠心病的患者，评估了一种新型长效慢钙通道阻滞剂氨氯地平的血流动力学剂量 - 反应效应。在静息状态下，经过对照生理盐水期后，对10例患者静脉注射4剂该药（累积剂量为1.25、2.5、5和10毫克），并在注射后10至15分钟测定血流动力学。仅在最大累积剂量后，对循环参数的影响才明显。因此，在另外10例患者中，给药方案加倍（静脉累积剂量为2.5、5、10和20毫克）。在每项研究中，通过比较对照运动期和最终累积剂量后的数值，评估恒负荷仰卧位自行车运动期间的血流动力学效应。在较高给药方案下，氨氯地平显著降低静息时的收缩压、舒张压和平均（p<0.01）体循环动脉压以及体循环血管阻力指数（p<0.01）。心率（p<0.01）、每搏量指数（p<0.01）和心脏指数（p<0.01）增加；肺动脉闭塞压未改变。在恒负荷自行车运动期间，平均动脉压显著降低（p<0.01），心率和心脏指数增加（p<0.01）。因此，氨氯地平对稳定型冠心病的即时影响是降低左心室后负荷并增强心脏泵血功能。静脉注射的最小有效剂量似乎为10毫克。氨氯地平似乎前景良好，值得在缺血性心脏病中进行长期研究。
