Wolfe C L, Tilton G D, Hillis L D, el Ashram N, Winniford M D
Am J Cardiol. 1985 Jul 1;56(1):47-50. doi: 10.1016/0002-9149(85)90564-8.
Because the combined use of a beta-adrenergic blocking agent and a calcium antagonist may be beneficial in some patients with severe angina, the acute hemodynamic and electrophysiologic effects of intravenous propranolol in the presence and absence of oral diltiazem treatment was studied. In 22 patients (11 men, 11 women, mean age 50 years), 12 receiving diltiazem (mean 243 mg/day, range 180 to 360) and 10 not receiving diltiazem, hemodynamic and electrophysiologic variables were measured before and 5 minutes after intravenous propranolol (0.1 mg/kg). Cardiac index (by thermodilution) and left ventricular (LV) peak dP/dt fell and LV end-diastolic pressure increased similarly in both groups. Mean systemic arterial pressure was unchanged. Coronary sinus blood flow (by thermodilution) decreased slightly in patients receiving diltiazem and was unchanged in those not receiving it. Propranolol caused a similar reduction in heart rate and increase in atrio-His conduction in both groups. Thus, when intravenous propranolol is given to patients with normal or only mildly depressed LV systolic function, the hemodynamic and electrophysiologic effects are similar in those receiving and not receiving oral diltiazem.
由于β-肾上腺素能阻滞剂与钙拮抗剂联合使用可能对某些重症心绞痛患者有益，因此研究了在口服地尔硫䓬治疗存在和不存在的情况下静脉注射普萘洛尔的急性血流动力学和电生理效应。在22例患者（11例男性，11例女性，平均年龄50岁）中，12例接受地尔硫䓬治疗（平均243mg/天，范围180至360mg），10例未接受地尔硫䓬治疗，在静脉注射普萘洛尔（0.1mg/kg）前和注射后5分钟测量血流动力学和电生理变量。两组的心脏指数（通过热稀释法）和左心室（LV）峰值dP/dt均下降，左心室舒张末期压力均有相似升高。平均体循环动脉压未改变。接受地尔硫䓬治疗的患者冠状窦血流量（通过热稀释法）略有下降，未接受地尔硫䓬治疗的患者冠状窦血流量未改变。普萘洛尔使两组患者的心率有相似程度降低，房室-希氏束传导有相似程度增加。因此，当对左心室收缩功能正常或仅轻度降低的患者静脉注射普萘洛尔时，接受和未接受口服地尔硫䓬治疗的患者其血流动力学和电生理效应相似。
