Pagani M, Pizzinelli P, Furlan R, Guzzetti S, Rimoldi O, Sandrone G
Institute for Cardiovascular Research, L Sacco Hospital, University of Milan, Italy.
Cardiovasc Res. 1987 Jan;21(1):55-64. doi: 10.1093/cvr/21.1.55.
The cardiac systolic and diastolic effects of the two major calcium blockers, verapamil and nifedipine, were studied and compared with those produced by dilazep, a relatively new vasodilator with calcium blocking properties, in conscious instrumented dogs to avoid the complications of anaesthesia and recent surgery. Mean arterial pressure was reduced by nifedipine and dilazep but not by verapamil, whereas peak left ventricular pressure was reduced only by dilazep and verapamil. Consistent tachycardia occurred, the rate being highest with nifedipine and lowest with dilazep. Left ventricular dP/dt was unaffected by dilazep, reduced by verapamil, and increased by nifedipine; this increase was no longer observed after beta adrenergic blockade. Ventricular relaxation was assessed by calculating the time relaxation constant, tau. Verapamil increased tau significantly only after beta adrenergic blockade, whereas nifedipine and dilazep reduced it both before and after beta adrenergic blockade. These data suggest that reflex beta adrenergic mechanisms may modulate the effects of calcium blockade on both systolic and diastolic performance.
在清醒的、装有仪器的犬身上研究并比较了两种主要钙阻滞剂维拉帕米和硝苯地平的心脏收缩和舒张效应,以及与具有钙阻滞特性的相对较新的血管扩张剂地拉齐普所产生的效应,以避免麻醉和近期手术的并发症。硝苯地平和地拉齐普可降低平均动脉压,但维拉帕米无此作用;而仅地拉齐普和维拉帕米可降低左心室峰值压力。出现了持续性心动过速,心率以硝苯地平最高,地拉齐普最低。左心室dP/dt不受地拉齐普影响,被维拉帕米降低,被硝苯地平升高;β肾上腺素能阻断后不再观察到这种升高。通过计算时间松弛常数tau来评估心室舒张。仅在β肾上腺素能阻断后维拉帕米才显著增加tau,而硝苯地平和地拉齐普在β肾上腺素能阻断前后均降低tau。这些数据表明,反射性β肾上腺素能机制可能调节钙阻滞对收缩和舒张功能的影响。