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双异丙吡胺对心脏直视手术后患者的血流动力学影响。

Haemodynamic effects of disopyramide in patients after open-heart surgery.

作者信息

Naqvi N, Thompson D S, Morgan W E, Williams B T, Coltart D J

出版信息

Br Heart J. 1979 Nov;42(5):587-94. doi: 10.1136/hrt.42.5.587.

Abstract

Disopyramide phosphate was administered intravenously in a dose of 1.2 mg/kg body weight over one minute to nine patients after open-heart surgery and coronary artery bypass grafting. The haemodynamic changes were studied during and for 30 minutes after drug administration. Heart rate was unchanged throughout the study. During infusion the only significant changes were an increase in systemic blood pressure and systolic impedance signifying a direct increase in peripheral arterial resistance. Systemic blood pressure remained significantly higher for 10 minutes and systolic impedance for 30 minutes. Immediately after infusion max. dPower/dT, a measure of ventricular contractility, was significantly depressed for 15 minutes. Both cardiac output and aortic flow were significantly depressed for 30 minutes. DPTI/TTI, an estimate of subendocardial supply/demand ratio, showed an insignificant increase throughout the study. This study shows that intravenous disopyramide starts acting within 45 seconds of the start of infusion, directly increases peripheral arterial resistance, has a breif negative inotropic action, and does not reduce subendocardial blood flow.

摘要

对9例心脏直视手术和冠状动脉搭桥术后的患者,以1.2mg/kg体重的剂量在1分钟内静脉注射磷酸丙吡胺。在给药期间及给药后30分钟研究血流动力学变化。在整个研究过程中,心率未发生变化。在输注期间,唯一显著的变化是全身血压升高和收缩期阻抗增加,这表明外周动脉阻力直接增加。全身血压在10分钟内仍显著升高,收缩期阻抗在30分钟内显著升高。输注后即刻,衡量心室收缩力的最大dPower/dT在15分钟内显著降低。心输出量和主动脉血流量在30分钟内均显著降低。DPTI/TTI(一种估计心内膜下供血/需求比率的指标)在整个研究过程中显示出不显著的增加。本研究表明,静脉注射丙吡胺在输注开始后45秒内开始起效,直接增加外周动脉阻力,具有短暂的负性肌力作用,且不减少心内膜下血流。

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本文引用的文献

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Cardiovascular effects of a newer antiarrhythmic agent, disopyramide phosphate.
Am Heart J. 1972 Dec;84(6):764-70. doi: 10.1016/0002-8703(72)90069-5.

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