Sievert H, Kunkel B, Wirtz M, Hopf R, Kaltenbach M
Dtsch Med Wochenschr. 1987 Jun 12;112(24):952-4. doi: 10.1055/s-2008-1068173.
In an open, randomized cross-over trial lasting two months, 21 patients with latent cardiomyopathy were either untreated or received verapamil 120 mg three times daily. Angina and dyspnea improved in 14 of the 21 patients. These symptoms worsened in one, remained unchanged in six (P less than 0.05). During exercise the pulmonary artery diastolic pressure fell from a mean of 25.3 +/- 7.6 to 20.1 +/- 6.6 mm Hg (P less than 0.05); (at rest, from mean of 10.7 +/- 5.2 to 9.0 +/- 4.5 mm Hg - not significant). In nine patients with a raised resting PA diastolic pressure verapamil produced a significant reduction (from 15.4 +/- 2.7 to 11.1 +/- 4.1 mm Hg) (P less than 0.05). All other hemodynamic parameters remained unchanged. These clinically and hemodynamically favorable effects are possibly due to improved diastolic ventricular function by verapamil. In latent cardiomyopathy any impairment of diastolic relaxation may be more important pathogenetically than reduction in systolic ventricular function.
在一项为期两个月的开放性随机交叉试验中，21例隐匿性心肌病患者要么未接受治疗，要么每日三次服用120毫克维拉帕米。21例患者中有14例的心绞痛和呼吸困难症状有所改善。其中1例症状恶化，6例症状无变化（P小于0.05）。运动期间，肺动脉舒张压从平均25.3±7.6毫米汞柱降至20.1±6.6毫米汞柱（P小于0.05）；（静息时，从平均10.7±5.2毫米汞柱降至9.0±4.5毫米汞柱，无统计学意义）。在9例静息肺动脉舒张压升高的患者中，维拉帕米使其显著降低（从15.4±2.7毫米汞柱降至11.1±4.1毫米汞柱）（P小于0.05）。所有其他血流动力学参数均保持不变。这些临床和血流动力学方面的有益作用可能归因于维拉帕米改善了心室舒张功能。在隐匿性心肌病中，舒张期松弛功能的任何损害在发病机制上可能比心室收缩功能降低更为重要。
