Iida K, Matsuda M, Ajisaka R, Sugishita Y, Ito I, Takeda T, Ooshima M, Akisada M
Department of Internal Medicine, University of Tsukuba, Ibaraki, Japan.
Jpn Heart J. 1987 Jul;28(4):495-506. doi: 10.1536/ihj.28.495.
The purpose of this study was to evaluate the acute effects of sublingual nifedipine (10 mg) on left ventricular systolic function (ejection fraction, peak ejection rate, time to peak ejection rate) and diastolic function (peak filling rate, time to peak filling rate, filling fraction during rapid filling) at rest and during exercise using radionuclide angiography in 17 patients with ischemic heart disease. The results of the study were as follows. Diastolic indexes in the patient group were significantly different from the values in the control group at rest and during exercise. Peak filling rate and filling fraction improved significantly after nifedipine administration. These values did not show significant differences from the values in normal subjects which were obtained before nifedipine administration. The peak filling rate during exercise after nifedipine administration increased significantly, although the value was lower than that in the control group. At rest, systolic indexes in the patient group showed abnormal values, although the differences from the control values were not significant. Ejection fraction and peak ejection rate were significantly lower than those in the control group during exercise. After nifedipine administration, peak ejection rate at rest and during exercise, and ejection fraction at rest in the patient group improved significantly. Seven of 17 achieved the same exercise workloads as control conditions without symptoms or ECG changes. These data suggest that nifedipine improved left ventricular systolic and diastolic dysfunction, as well as exercise tolerance in patients with ischemic heart disease.
本研究旨在利用放射性核素血管造影术,评估17例缺血性心脏病患者静息及运动状态下,舌下含服硝苯地平(10毫克)对左心室收缩功能(射血分数、峰值射血率、达峰值射血率时间)和舒张功能(峰值充盈率、达峰值充盈率时间、快速充盈期充盈分数)的急性影响。研究结果如下。患者组的舒张指标在静息及运动状态下与对照组的值均有显著差异。服用硝苯地平后,峰值充盈率和充盈分数显著改善。这些值与服用硝苯地平前正常受试者的值相比无显著差异。服用硝苯地平后运动时的峰值充盈率虽低于对照组,但显著增加。静息时,患者组的收缩指标显示异常值,尽管与对照值的差异不显著。运动时,射血分数和峰值射血率显著低于对照组。服用硝苯地平后,患者组静息及运动时的峰值射血率以及静息时的射血分数显著改善。17例患者中有7例达到了与对照情况相同的运动负荷,且无任何症状或心电图变化。这些数据表明,硝苯地平改善了缺血性心脏病患者的左心室收缩和舒张功能障碍以及运动耐量。