Singh B N, Roche A H
Am Heart J. 1977 Nov;94(5):593-9. doi: 10.1016/s0002-8703(77)80128-2.
The hemodynamic effects of intravenous verapamil (10 mg.) were evaluated in 13 patients with coronary artery disease and in seven patients with rheumatic valvular disease during cardiac catheterization. The peak effects were apparent at 3 to 5 minutes after injection and lasted about 10 minutes. The mean arterial pressure fell from 97.8 +/- 3.4 to 85.9 +/- 2.7 mm. Hg (-12%; p less than 0.01) accompanied by a significant decrease (-21%, p less than 0.001) in systemic vascular resistance (from 1435 +/- 80 to 1131 +/- 82 dynes-sex.-cm.-5) with an increase in left ventricular end-diastolic pressure (from 11.0 +/- 0.9 to 15.0 +/- 1.0 mm. Hg; +36%, p less than 0.01) and a reduction in LV dp/dt max (from 1343 +/- 152 to 1007 +/- 102 mm. Hg/sex.; -25%, p less than 0.05). The changes in heart rate (from 75.7 +/- 3.0 to 80.2 +/- 2.8 beats/min.), cardiac index (from 3.17 +/- 0.15 to 3.61 +/- 0.17 L./min./M.2), left ventricular minute work (from 3.63 +/- 0.28 to 3.31 +/- 0.23 Kg.-m./min./M.2) and mean pulmonary artery pressures (from 15.7 +/- 1.0 to 18.1 +/- 0.8 mm. Hg) were not statistically significant. The intrinsic negative inotropic action of verapamil is, therefore, minimized by its effect on afterload so that cardiac index is not reduced by the drug in patients with cardiac disease.
在心脏导管插入术期间，对13例冠心病患者和7例风湿性瓣膜病患者评估了静脉注射维拉帕米（10毫克）的血流动力学效应。注射后3至5分钟出现峰值效应，持续约10分钟。平均动脉压从97.8±3.4降至85.9±2.7毫米汞柱（-12%；p<0.01），同时全身血管阻力显著降低（-21%，p<0.001）（从1435±80降至1131±82达因·秒·厘米⁻⁵），左心室舒张末期压力升高（从11.0±0.9升至15.0±1.0毫米汞柱；+36%，p<0.01），左心室dp/dt max降低（从1343±152降至1007±102毫米汞柱/秒；-25%，p<0.05）。心率（从75.7±3.0升至80.2±2.8次/分钟）、心脏指数（从3.17±0.15升至3.61±0.17升/分钟/平方米）、左心室每分钟作功（从3.63±0.28降至3.31±0.23千克·米/分钟/平方米）和平均肺动脉压（从15.7±1.0升至18.1±0.8毫米汞柱）的变化无统计学意义。因此，维拉帕米对后负荷的作用使其内在负性肌力作用最小化，从而该药物不会降低心脏病患者的心脏指数。
