Bedotto J B, Lee R W, Lancaster L D, Olajos M, Goldman S
Department of Internal Medicine, Veterans Administration Medical Center, Tucson, Arizona 85723.
J Am Coll Cardiol. 1988 Jun;11(6):1337-42. doi: 10.1016/0735-1097(88)90301-4.
The effects of cocaine on the heart and peripheral circulation were examined in seven mongrel dogs. Hemodynamic variables, in addition to data on ventricular relaxation, mean circulatory filling pressure and arterial compliance, were measured during an intravenous infusion (0.5 mg/kg per min) of cocaine. Holter monitor recordings (6 h) and coronary arteriograms were also obtained. Cocaine increased (p less than 0.01) mean aortic pressure from 72 +/- 5 to 92 +/- 5, left ventricular systolic pressure from 102 +/- 3 to 121 +/- 5, left ventricular end-diastolic pressure from 4.9 +/- 1.3 to 8.2 +/- 1.4 and mean circulatory filling pressure from 7.9 +/- 0.4 to 10.9 +/- 0.5 mm Hg. Cardiac index and stroke volume decreased (p less than 0.01) from 166 +/- 17 to 125 +/- 8 ml/min per kg and from 44 +/- 4 to 29 +/- 3 ml, respectively. Ejection fraction decreased (p less than 0.01) from 61 +/- 1 to 49 +/- 3%. Heart rate, first derivative of left ventricular pressure (dP/dt) and right atrial, mean pulmonary artery and pulmonary artery wedge pressures did not change. The result was a 58% increase in systemic vascular resistance and a 32% decrease in arterial compliance. The pressure gradient for venous return did not change, but resistance to venous return increased 42%. Cocaine prolonged (p less than 0.05) the half-time of left ventricular isovolumic relaxation from 13.4 +/- 0.8 to 16.4 +/- 0.8 ms and the time constant of left ventricular isovolumic relaxation from 19.3 +/- 1.2 to 23.6 +/- 1.1 ms.(ABSTRACT TRUNCATED AT 250 WORDS)
在7只杂种狗身上研究了可卡因对心脏和外周循环的影响。在静脉输注可卡因(每分钟0.5毫克/千克)期间,除了测量心室舒张、平均循环充盈压和动脉顺应性的数据外,还测量了血流动力学变量。同时还获取了动态心电图监测记录(6小时)和冠状动脉造影。可卡因使平均主动脉压从72±5毫米汞柱升高至92±5毫米汞柱(p<0.01),左心室收缩压从102±3毫米汞柱升高至121±5毫米汞柱,左心室舒张末期压力从4.9±1.3毫米汞柱升高至8.2±1.4毫米汞柱,平均循环充盈压从7.9±0.4毫米汞柱升高至10.9±0.5毫米汞柱。心脏指数和每搏输出量分别从166±17降至125±8毫升/分钟·千克和从44±4降至29±3毫升(p<0.01)。射血分数从61±1%降至49±3%(p<0.01)。心率、左心室压力的一阶导数(dP/dt)以及右心房、平均肺动脉和肺动脉楔压均未改变。结果是全身血管阻力增加58%,动脉顺应性降低32%。静脉回流的压力梯度未改变,但静脉回流阻力增加42%。可卡因使左心室等容舒张的半衰期从13.4±0.8毫秒延长至16.4±0.8毫秒(p<0.05),左心室等容舒张的时间常数从19.3±1.2毫秒延长至23.6±1.1毫秒。(摘要截选至250字)