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某些抗心律失常药物对正常受试者收缩期时间间期的影响(作者译)

[The effect of some antiarrhythmic drugs on systolic time intervals in normal subjects (author's transl)].

作者信息

Breithardt G, Jochum E, Kuhn H, Seipel L

出版信息

Z Kardiol. 1978 Oct;67(10):6,0-7.

PMID:366939
Abstract

Eleven healthy volunteers (mean age 30.1 +/- 4.3 yrs.) were repeatedly studied by measurement of systolic time intervals (QS2c, PEPc, LVETc, PEP/LVET) and arterial blood pressure (cuff method) before and after 24-hour oral application of four antiarrhythmic drugs (quinidine, disopyramide, prajmaliumbitartrate, propafenone) and two beta-blocking agents (propranolol, atenolol). The studies were repeated in the same group of volunteers with a different drug after an interval of one week. PEPc significantly increased after all antiarrhythmic agents at therapeutic doses by 6.1 to 9.4 ms (p less than 0.05 and p less than 0.01 resp.), whereas LVETc did not change significantly. PEP/LVET increased on an average by 0.033 +/- 0.006 (p less than 0.01). QS2c increased by 7.5 and 7.6 ms resp. (p less than 0.05) after prajmaliumbitartrate and propafenone. Heart rate remained unchanged after disopyramide and propafenone whereas it increased significantly (p less than 0.05) after quinidine and prajmaliumbitartrate. Blood pressure did not change significantly after any of these antiarrhythmic drugs. After application of the two beta-blocking agents propranolol and atenolol, no significant changes in STI could be observed. Mean arterial blood pressure significantly dropped after both, propranolol (minus 2.8 mm Hg) and atenolol (minus 9.7 mm Hg; p less than 0.05 and p less than 0.01, resp.). Heart rate decreased by minus 8.1 b.p.m. after propranolol (p less than 0.01) and minus 11.5 b.p.m. after atenolol (p less than 0.01). The results clearly indicate that at the dosage used, the four antiarrhythmic agents (quinidine, disopyramide, prajmaliumbitartrate, propafenone) exert a negative inotropic effect on left ventricular function as far as it can be judged from the measurement of STI. The lack of a significant negative inotropic effect of an oral treatment with beta-blocking agents on the STI can be explained by opposing effects of a decrease in blood pressure and a negative inotropic action.

摘要

11名健康志愿者(平均年龄30.1±4.3岁)在口服4种抗心律失常药物(奎尼丁、双异丙吡胺、丙吡胺、普罗帕酮)和2种β受体阻滞剂(普萘洛尔、阿替洛尔)24小时前后,通过测量收缩期时间间期(QS2c、PEPc、LVETc、PEP/LVET)和动脉血压(袖带法)进行了反复研究。在间隔一周后,对同一组志愿者使用不同药物重复进行研究。治疗剂量的所有抗心律失常药物使用后,PEPc均显著增加6.1至9.4毫秒(分别为p<0.05和p<0.01),而LVETc无显著变化。PEP/LVET平均增加0.033±0.006(p<0.01)。丙吡胺和普罗帕酮使用后,QS2c分别增加7.5和7.6毫秒(p<0.05)。双异丙吡胺和普罗帕酮使用后心率保持不变,而奎尼丁和丙吡胺使用后心率显著增加(p<0.05)。这些抗心律失常药物使用后血压均无显著变化。使用两种β受体阻滞剂普萘洛尔和阿替洛尔后,未观察到STI有显著变化。普萘洛尔(-2.8毫米汞柱)和阿替洛尔(-9.7毫米汞柱;分别为p<0.05和p<0.01)使用后平均动脉血压均显著下降。普萘洛尔使用后心率下降8.1次/分钟(p<0.01),阿替洛尔使用后心率下降11.5次/分钟(p<0.01)。结果清楚地表明,在所使用的剂量下,从STI测量判断,4种抗心律失常药物(奎尼丁、双异丙吡胺、丙吡胺、普罗帕酮)对左心室功能有负性肌力作用。口服β受体阻滞剂治疗对STI缺乏显著的负性肌力作用,可通过血压降低和负性肌力作用的相反效应来解释。

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