Rocha P, Baron B, Delestrain A, Pathe M, Cazor J L, Kahn J C
Am Heart J. 1986 Jan;111(1):62-8. doi: 10.1016/0002-8703(86)90554-5.
In the search for any deleterious hemodynamic effects of the acute administration of intravenous diltiazem (0.25 mg/kg), in patients on beta blockers, studies were performed in two comparable groups of eight patients with chronic coronary heart disease without clinical signs of heart failure. In the first group, with no previous treatment, the only significant variations observed were a decrease in systemic vascular resistance (p less than 0.01) and an increase in cardiac index (p less than 0.01), which were noted only at 5 minutes. In the second group, receiving long-term oral doses of 120 to 240 mg/day of propranolol, at 5 minutes, despite a slight decrease in peak positive first derivative of left ventricular pressure (p less than 0.05), cardiac index and systolic index increased (p less than 0.05 and p less than 0.01) with decreases in systemic vascular resistance (p less than 0.01) and mean blood pressure (p less than 0.05); at 15 minutes, systemic vascular resistance was still decreased (p less than 0.05) and cardiac index and systolic index were still increased (p less than 0.05). In conclusion, intravenous administration of diltiazem (0.25 mg/kg) to patients with chronic coronary heart disease and no evidence of congestive heart failure, who were receiving propranolol, was safe and prevented, in these patients, the potential deleterious effects of beta blockers, that is, increased peripheral vascular resistance and decreased cardiac output.
为研究静脉注射地尔硫䓬（0.25mg/kg）对使用β受体阻滞剂的患者的急性血流动力学影响，我们对两组各8例无心力衰竭临床症状的慢性冠心病患者进行了研究。第一组患者此前未接受过治疗，仅在5分钟时观察到全身血管阻力下降（p<0.01）和心脏指数增加（p<0.01）这两个显著变化。第二组患者长期口服普萘洛尔，剂量为120至240mg/天，在5分钟时，尽管左心室压力峰值一阶导数略有下降（p<0.05），但心脏指数和收缩指数增加（p<0.05和p<0.01），同时全身血管阻力下降（p<0.01）和平均血压下降（p<0.05）；在15分钟时，全身血管阻力仍下降（p<0.05），心脏指数和收缩指数仍增加（p<0.05）。总之，对接受普萘洛尔治疗且无充血性心力衰竭证据的慢性冠心病患者静脉注射地尔硫䓬（0.25mg/kg）是安全的，并且在这些患者中预防了β受体阻滞剂的潜在有害作用，即外周血管阻力增加和心输出量减少。
