De Kock M, Melin J A, Nannan M E, Robert A, Beckers C, Lavenne F, Detry J M
Eur Heart J. 1986 Sep;7(9):792-9. doi: 10.1093/oxfordjournals.eurheartj.a062141.
This study was undertaken to determine the chronic effects of a long-acting calcium-channel blocker (nitrendipine) on resting left ventricular filling abnormalities in ten patients with essential hypertension. Radionuclide left ventricular curves of these hypertensive patients were compared with the curves of twelve normal volunteers and of eight asymptomatic older patients. The curves were analyzed for ejection fraction, peak filling rate (normalized for end-diastolic counts and for stroke counts), time to peak filling rate and filling fraction in the first-third of diastole normalized for cycle length. Heart rate and ejection fraction were similar in both control groups and hypertensive patients before and after nitrendipine. Before nitrendipine, diastolic filling parameters were significantly different in the hypertensive patients as compared with the volunteers and with the asymptomatic aged patients: peak filling rate was lower, time to peak filling rate was longer and the first-third filling fraction was smaller. After six weeks of nitrendipine therapy, systolic and diastolic blood pressure decreased significantly. After nitrendipine, the time to peak filling rate decreased and the first-third filling fraction and the peak filling rate (normalized for stroke counts) increased significantly. The acute oral administration of 100 mg atenolol induced a further decrease in systolic blood pressure and a significant decrease in heart rate. The effect of combining nitrendipine and atenolol on diastolic indexes was a preserved effect on time to peak filling rate and on the first-third filling fraction. These results suggest that short-term therapy with nitrendipine improves early diastolic dysfunction in hypertensives: the addition of a beta-blocking agent further improved the early diastolic indexes.
本研究旨在确定长效钙通道阻滞剂（尼群地平）对10例原发性高血压患者静息时左心室充盈异常的慢性影响。将这些高血压患者的放射性核素左心室曲线与12名正常志愿者及8名无症状老年患者的曲线进行比较。分析曲线的射血分数、峰值充盈率（根据舒张末期计数和每搏量计数进行标准化）、达到峰值充盈率的时间以及舒张期前三分之一的充盈分数（根据心动周期长度进行标准化）。尼群地平治疗前后，对照组和高血压患者的心率和射血分数相似。在使用尼群地平之前，高血压患者的舒张期充盈参数与志愿者及无症状老年患者相比有显著差异：峰值充盈率较低，达到峰值充盈率的时间较长，舒张期前三分之一的充盈分数较小。经过六周的尼群地平治疗后，收缩压和舒张压显著下降。使用尼群地平后，达到峰值充盈率的时间缩短，舒张期前三分之一的充盈分数和峰值充盈率（根据每搏量计数进行标准化）显著增加。急性口服100 mg阿替洛尔可使收缩压进一步降低，心率显著下降。联合使用尼群地平和阿替洛尔对舒张期指标的影响是对达到峰值充盈率的时间和舒张期前三分之一的充盈分数仍有改善作用。这些结果表明，尼群地平短期治疗可改善高血压患者的早期舒张功能障碍：加用β受体阻滞剂可进一步改善早期舒张期指标。
