Pratt C M, Young J B, Wierman A M, Borland R M, Seals A A, Leon C A, Raizner A, Quinones M A, Roberts R
Am J Med. 1986 Apr;80(4):626-32. doi: 10.1016/0002-9343(86)90818-1.
On the basis of epidemiologic studies, more than 10 million Americans have echocardiographic evidence of mitral valve prolapse. Although ventricular arrhythmias occur frequently (over 50 percent of patients with mitral valve prolapse), they rarely result in sustained ventricular tachycardia or sudden cardiac death. However, a common problem in clinical practice is a patient with mitral valve prolapse and symptomatic complex ventricular arrhythmias refractory or intolerant to both beta blockers and conventional type I antiarrhythmics. These drugs are known to have frequent side effects, toxicity, and proarrhythmic effects. In 17 patients with mitral valve prolapse who presented with symptomatic complex ventricular arrhythmias and who were unresponsive to an average of the three conventional agents, moricizine (Ethmozine) was effective in suppressing 90 percent of ventricular premature depolarizations, 99 percent of nonsustained runs of ventricular tachycardia, as well as all sustained runs of ventricular tachycardia, resulting in abolition of palpitations, dizziness, and syncopal episodes. Its efficacy as well as its low frequency of minor side effects makes it ideal for future consideration in the population with mitral valve prolapse, who are frequently young and may therefore require therapy for many years.
根据流行病学研究，超过1000万美国人有二尖瓣脱垂的超声心动图证据。虽然室性心律失常频繁发生（超过50%的二尖瓣脱垂患者），但很少导致持续性室性心动过速或心源性猝死。然而，临床实践中的一个常见问题是二尖瓣脱垂患者伴有有症状的复杂性室性心律失常，对β受体阻滞剂和传统I类抗心律失常药均难治或不耐受。已知这些药物有频繁的副作用、毒性和促心律失常作用。在17例二尖瓣脱垂伴症状性复杂性室性心律失常且对平均三种传统药物无反应的患者中，莫雷西嗪（乙吗噻嗪）能有效抑制90%的室性早搏、99%的非持续性室性心动过速发作以及所有持续性室性心动过速发作，从而消除心悸、头晕和晕厥发作。其疗效以及轻微副作用发生率低，使其成为二尖瓣脱垂人群未来治疗的理想选择，这些患者往往年轻，因此可能需要多年治疗。
