[莫索尼定对慢性充血性心力衰竭的血流动力学影响]

[Hemodynamic effects of molsidomine in chronic congestive heart failure].

作者信息

Humar F, Maras P, Musitelli G, Camerini F

出版信息

G Ital Cardiol. 1986 May;16(5):427-32.

Abstract

Acute haemodynamic effects of molsidomine, antianginal drug with vasodilator properties, were evaluated in 12 male patients with chronic congestive heart failure in New York Heart Association functional class 3 or 4 (mean age 56 +/- 7 years; ischemic heart disease in 8 cases, dilated cardiomyopathy in 3 cases, heart disease of combined aetiology in 1 case). After sublingual molsidomine (4 mg: 6 cases; 8 mg: 6 cases) the following haemodynamic changes were observed: mean right atrial pressure - 35% (p less than 0.01), left ventricular filling pressure -30% (p less than 0.01), total pulmonary resistance -33% (p less than 0.01), pulmonary arteriolar resistance -32% (p less than 0.01), cardiac index -6% (p less than 0.05), stroke volume index -12% (p less than 0.05), stroke work index +18% (p less than 0.01), heart rate -6% (p less than 0.01), double product -10% (p less than 0.01) (Fig. 3). Peak haemodynamic effect was reached between 30 and 90 minutes, lasting till 180 minutes. Molsidomine acutely reduced preload, did not show side effects and was well tolerated. These results suggest that molsidomine might be used in the treatment of chronic congestive heart failure, especially if characterized by an increased right and left ventricular filling pressure.

摘要

评估了具有血管舒张特性的抗心绞痛药物吗多明对12例纽约心脏协会心功能3或4级的慢性充血性心力衰竭男性患者（平均年龄56±7岁；8例为缺血性心脏病，3例为扩张型心肌病，1例为病因组合型心脏病）的急性血流动力学效应。舌下含服吗多明（4毫克：6例；8毫克：6例）后，观察到以下血流动力学变化：平均右心房压降低35%（p<0.01），左心室充盈压降低30%（p<0.01），总肺阻力降低33%（p<0.01），肺小动脉阻力降低32%（p<0.01），心脏指数降低6%（p<0.05），每搏量指数降低12%（p<0.05），每搏功指数增加18%（p<0.01），心率降低6%（p<0.01），双乘积降低10%（p<0.01）（图3）。血流动力学效应峰值在30至90分钟之间达到，持续至180分钟。吗多明可急性降低前负荷，无副作用且耐受性良好。这些结果表明，吗多明可能用于治疗慢性充血性心力衰竭，特别是在左右心室充盈压升高的情况下。