Székely A, Csatáry A, Szilánk K, Kiss R, Dénes F
Department of Anaesthesiology, Postgraduate Medical University, Budapest, Hungary.
Acta Physiol Hung. 1988;72 Suppl:111-9.
The effect of oral Tensiomin treatment, 53.4 mg daily in 29 patients suffering from congestive heart failure associated with acute of chronic forms of ischaemic heart disease, e.g., recent and/or advanced myocardial infarction, aneurysm etc. was studied. The acute and long-term beneficial haemodynamic effects were verified in 4 patients by thermodilution Swan-Ganz catheterization as well. The parameters of ejection function improved moderately, while left ventricular filling pressure (PCW) decreased significantly. The balanced vasodilator effect was not accompanied by an increased myocardial oxygen demand. The "double product" was lowered in response to Tensiomin. During the clinical follow-up (from 6 days to 2 years) there was an improvement in the NYHA functional class by an average of 1.2 however 4 patients died in spite of combined vasodilator and dobutamine treatment. Owing to the improvement of regional blood flow to the brain and the kidney Tensiomin seems to be well-tolerated in patients with low arterial blood pressure. In pts with acute myocardial infarction and angina the critical fall of blood pressure and that of the coronary blood flow should be avoided by giving the drug in approximately titrated. Side effects were observed only with higher doses of Tensiomin in a small number of patients, i.e., transient worsening of renal function in 3 patients and dysgeusia in 2. Our data indicate that Tensiomin treatment is effective and safe in patients suffering from all kinds of congestive heart failure complicating ischaemic heart disease.
研究了口服坦西明（Tensiomin）的疗效，该药物每日剂量为53.4毫克，用于29例患有与急性或慢性缺血性心脏病相关的充血性心力衰竭的患者，例如近期和/或晚期心肌梗死、动脉瘤等。通过热稀释法用Swan - Ganz导管插入术在4例患者中验证了急性和长期有益的血流动力学效应。射血功能参数适度改善，而左心室充盈压（PCW）显著降低。平衡的血管扩张作用并未伴随着心肌需氧量的增加。坦西明使“双乘积”降低。在临床随访期间（从6天到2年），纽约心脏协会（NYHA）功能分级平均改善了1.2级，然而，尽管联合使用了血管扩张剂和多巴酚丁胺治疗，仍有4例患者死亡。由于坦西明改善了脑和肾的局部血流，低血压患者似乎对其耐受性良好。在急性心肌梗死和心绞痛患者中，应通过大致滴定给药来避免血压和冠状动脉血流的严重下降。仅在少数患者中使用较高剂量的坦西明时观察到副作用，即3例患者出现肾功能短暂恶化，2例患者出现味觉障碍。我们的数据表明，坦西明治疗对于患有各种并发缺血性心脏病的充血性心力衰竭患者是有效且安全的。
