Sievert H, Kunkel B, Wirtz M, Hopf R, Kaltenbach M
Department of Cardiology, J.W. Goethe-University, University Hospital Frankfurt, F.R.G.
Z Kardiol. 1987;76 Suppl 3:164-6.
Twenty-one patients with a mild form of cardiomyopathy (with normal ejection fraction but histologically-confirmed hypertrophy of myocardial cells and/or elevated diastolic pulmonary artery pressure during exercise) received 120 mg verapamil t.i.d. or no therapy at all for a period of 2 months in an open randomized cross-over study. Out of the 21 patients, 14 improved clinically, one patient's condition deteriorated and six remained unchanged (p less than 0.05). The mean diastolic pulmonary artery pressure during exercise decreased (25.3 +/- 7.6 to 20.1 +/- 6.6 mm Hg, n = 21, p less than 0.05). At rest, the decrease was only significant in the subgroup with pressures above 12 mm Hg (15.4 +/- 2.7 to 11.1 +/- 4.1 mm Hg, n = 9, p less than 0.05). All other hemodynamic data displayed no significant change. The benefits of verapamil therapy may be attributed to an improvement in diastolic ventricular function. The disturbance in diastolic relaxation might be of greater importance than the disturbance in systolic function in patients with mild forms of cardiomyopathy.
在一项开放性随机交叉研究中，21例轻度心肌病患者（射血分数正常，但组织学证实心肌细胞肥大和/或运动时舒张期肺动脉压升高）接受维拉帕米120毫克每日三次治疗，或在2个月内完全不接受治疗。21例患者中，14例临床症状改善，1例病情恶化，6例无变化（p<0.05）。运动时平均舒张期肺动脉压下降（从25.3±7.6降至20.1±6.6毫米汞柱，n=21，p<0.05）。静息时，仅在舒张压高于12毫米汞柱的亚组中有显著下降（从15.4±2.7降至11.1±4.1毫米汞柱，n=9，p<0.05）。所有其他血流动力学数据均无显著变化。维拉帕米治疗的益处可能归因于舒张期心室功能的改善。在轻度心肌病患者中，舒张期舒张功能障碍可能比收缩功能障碍更为重要。
