Pratt C M, Podrid P J, Seals A A, Young J B, Hession M, Lampert S, Quiñones M, Lown B
Cardiac Arrhythmia Study Unit, Baylor College of Medicine, Houston, Texas 77030.
Am J Cardiol. 1987 Oct 16;60(11):73F-78F. doi: 10.1016/0002-9149(87)90725-9.
Ventricular arrhythmias combined with left ventricular (LV) dysfunction in patients portend a poor prognosis. Most antiarrhythmic agents have not been sufficiently investigated to adequately describe detrimental effects on LV function; we report the effects of moricizine HCl on ventricular function in 4 trials highlighting patients with LV dysfunction. Quantitative 2-dimensional echocardiography was used to evaluate 81 patients pre- and posttreatment. There was no change in mean global LV ejection fraction (EF) during placebo compared with moricizine HCl therapy (47 +/- 15% vs 46 +/- 14%, p greater than 0.05). In a separate trial, radionuclide LVEF at rest and exercise tolerance testing were performed in 24 patients with life-threatening ventricular arrhythmias who had a mean control LVEF of 40 +/- 19%. No significant change during moricizine HCl therapy (38 +/- 19%, p greater than 0.05) was detected and exercise parameters were unchanged. Rest and exercise LV function was measured during right-sided heart catheterization in a placebo-controlled study of 20 patients with ventricular tachycardia. Moricizine HCl was well tolerated without hemodynamic deterioration in all but 3 patients, who could be identified by their inability to increase stroke volume index during exercise. Finally, the relation between initial LV function and resultant antiarrhythmic efficacy indicates that moricizine HCl controls arrhythmias best in patients with LVEF greater than 30%.
心室心律失常合并左心室（LV）功能障碍的患者预后较差。大多数抗心律失常药物尚未得到充分研究，无法充分描述其对左心室功能的有害影响；我们在4项试验中报告了盐酸莫雷西嗪对心室功能的影响，这些试验重点关注了左心室功能障碍患者。采用定量二维超声心动图对81例患者治疗前后进行评估。与盐酸莫雷西嗪治疗相比，安慰剂治疗期间左心室平均整体射血分数（EF）无变化（47±15%对46±14%，p>0.05）。在另一项试验中，对24例有危及生命的室性心律失常且平均对照左心室射血分数为40±19%的患者进行了静息放射性核素左心室射血分数和运动耐量测试。在盐酸莫雷西嗪治疗期间未检测到显著变化（38±19%，p>0.05），运动参数也未改变。在一项对20例室性心动过速患者的安慰剂对照研究中，在右侧心导管检查期间测量了静息和运动时的左心室功能。除3例患者外，盐酸莫雷西嗪耐受性良好，无血流动力学恶化，这3例患者可通过运动时无法增加每搏量指数来识别。最后，初始左心室功能与抗心律失常疗效之间的关系表明，盐酸莫雷西嗪在左心室射血分数大于30%的患者中控制心律失常的效果最佳。
