Funck F, Bourmayan C, Cristofini P, Desnos M, Fernandez F, Benoit P, Wajman A, Gay J
Service de cardiologie, Hôpital Boucicaut, Paris.
Arch Mal Coeur Vaiss. 1988 Apr;81(4):525-9.
None of the medical treatments of hypertrophic cardiomyopathy is perfect. In the present study conducted on 11 patients with hypertrophic cardiomyopathy in whom the usual treatments were either ineffective or badly tolerated, the haemodynamic effects of propafenone administered intravenously were investigated. The drug was injected centrally in doses of 2 mg/kg over 10 minutes, then by continuous intravenous infusion of 1.5 mg/min during 30 minutes. Various parameters were recorded before and after propafenone treatment by right and left cardiac catheterization. This anti-arrhythmic drug, which has beta-blocking and amiodarone-like properties, reduced left intraventricular obstruction but had no beneficial effect on diastolic function. The baseline and induced left intraventricular gradients were reduced from 30.4 to 17.7 mmHg and from 74 to 43 mmHg respectively. Diastolic function values showed a fall in dp/dt min from 1470 to 1307 mm/sec and an increase in T value from 0.066 to 0.084. The use of propafenone in hypertrophic cardiomyopathy must be accurately determined by long-term oral studies.
肥厚型心肌病的任何医学治疗方法都并非完美。在本研究中,对11例肥厚型心肌病患者进行了研究,这些患者常规治疗要么无效,要么耐受性差,研究了静脉注射普罗帕酮的血流动力学效应。药物以2mg/kg的剂量在10分钟内中心静脉注射,然后在30分钟内以1.5mg/分钟的速度持续静脉输注。在普罗帕酮治疗前后,通过左右心导管插入术记录各种参数。这种具有β受体阻滞和胺碘酮样特性的抗心律失常药物减轻了左心室内梗阻,但对舒张功能没有有益影响。基线和诱发的左心室内梯度分别从30.4mmHg降至17.7mmHg,从74mmHg降至43mmHg。舒张功能值显示dp/dt min从1470mm/sec降至1307mm/sec,T值从0.066增加到0.084。在肥厚型心肌病中使用普罗帕酮必须通过长期口服研究来准确确定。