Marin-Neto J A, Maciel B C, Secches A L, Gallo Júnior L
Cardiac Catheterization Laboratory, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo.
Clin Cardiol. 1988 Apr;11(4):253-60. doi: 10.1002/clc.4960110411.
Berberine, an alkaloid of the protoberberine family, has been shown to have strong positive inotropic and peripheral resistance-lowering effects in dogs with and without heart failure. To determine the acute cardiovascular effects of berberine in humans, 12 patients with refractory congestive heart failure were studied before and during berberine intravenous infusion at rates of 0.02 and 0.2 mg/kg per min for 30 minutes. The lower infusion dose produced no significant circulatory changes, apart from a reduction in heart rate (14%). The 0.2 mg/kg per min dose elicited several significant changes: (a) Decreases in systemic (48%, p less than 0.01) and pulmonary vascular resistance (41%, p less than 0.01), and in right atrium (28%, p less than 0.05) and left ventricular end-diastolic pressures (32%, p less than 0.01). (b) Increases in cardiac index (45%, p less than 0.01), stroke index (45%, p less than 0.01), and LV ejection fraction measured by contrast angiography (56%, p less than 0.01). (c) Increases in hemodynamic and echocardiographic indices of LV performance: peak measured velocity of shortening (45%, p less than 0.01), peak shortening velocity at zero load (41%, p less than 0.01), rate of development of pressure at developed isovolumic pressure of 40 mmHg (20%, p less than 0.01), percent fractional shortening (50%, p less than 0.01), and the mean velocity of circumferential fiber shortening (54%, p less than 0.01). (d) Decrease of arteriovenous oxygen difference (28%, p less than 0.05) with no changes in total body oxygen uptake, arterial oxygen tension, or hemoglobin dissociation properties.(ABSTRACT TRUNCATED AT 250 WORDS)
小檗碱是原小檗碱家族的一种生物碱，已被证明在患有和未患心力衰竭的犬类中具有强烈的正性肌力作用和降低外周阻力的作用。为了确定小檗碱对人体的急性心血管影响，对12例难治性充血性心力衰竭患者在静脉输注小檗碱前以及输注期间进行了研究，输注速率分别为每分钟0.02毫克/千克和0.2毫克/千克，持续30分钟。较低的输注剂量除了使心率降低（14%）外，未产生明显的循环变化。每分钟0.2毫克/千克的剂量引起了一些显著变化：（a）全身血管阻力（降低48%，p<0.01）和肺血管阻力（降低41%，p<0.01），以及右心房压力（降低28%，p<0.05）和左心室舒张末期压力（降低32%，p<0.01）。（b）心脏指数（增加45%，p<0.01）、每搏指数（增加45%，p<0.01）以及通过造影血管造影测量的左心室射血分数（增加56%，p<0.01）。（c）左心室功能的血流动力学和超声心动图指标增加：测量的最大缩短速度（增加45%，p<0.01）、零负荷时的最大缩短速度（增加41%，p<0.01）、在40毫米汞柱等容收缩压时压力上升速率（增加20%，p<0.01）、缩短分数百分比（增加50%，p<0.01）以及圆周纤维缩短平均速度（增加54%，p<0.01）。（d）动静脉氧差降低（28%，p<0.05），而全身氧摄取、动脉血氧张力或血红蛋白解离特性无变化。（摘要截取自250字）
