Goldstein R A, Gray E L, Dougherty A H, Naccarelli G V
Am J Cardiol. 1985 Jul 22;56(3):25B-28B. doi: 10.1016/0002-9149(85)91192-0.
Patients with congestive heart failure (CHF) have a high prevalence of complex ventricular arrhythmias. Accordingly, the electrophysiologic effects of new drugs for the treatment of CHF should be studied to determine whether they are safe in this population of patients. Fifteen patients with New York Heart Association functional classes II to IV CHF underwent hemodynamic and electrophysiologic testing during control conditions, and after 10 to 20 micrograms/kg/min of intravenous amrinone (dosages that increased cardiac output and decreased left ventricular filling pressures). All cardioactive drugs were stopped for at least 5 half-lives before entry into the study. Amrinone decreased the atrial effective refractory period from 256 to 240 ms (p = 0.015) and the AV nodal functional refractory period from 374 to 356 ms (p less than 0.05), and enhanced maximal 1:1 AV nodal conduction from 371 to 334 ms (p = 0.006). Prolonged HV intervals were present in 9 of 15 patients and were not affected by amrinone. Holter monitoring was performed in 10 patients during acute oral administration of amrinone. There were no significant changes in the frequency of ventricular extrasystoles or ventricular tachycardia, although the frequency of ventricular couples tended to increase slightly. Amrinone therefore enhances AV conduction and does not appear to have significant arrhythmogenic potential during acute administration.
充血性心力衰竭（CHF）患者复杂室性心律失常的发生率很高。因此，应研究治疗CHF的新药的电生理效应，以确定它们在这类患者中是否安全。15例纽约心脏协会心功能II至IV级的CHF患者在对照状态下以及静脉注射氨力农10至20微克/千克/分钟（这些剂量可增加心输出量并降低左心室充盈压）后，接受了血流动力学和电生理测试。在进入研究前，所有心血管活性药物均停用至少5个半衰期。氨力农使心房有效不应期从256毫秒降至240毫秒（p = 0.015），房室结功能不应期从374毫秒降至356毫秒（p < 0.05），并使最大1:1房室结传导从371毫秒增强至334毫秒（p = 0.006）。15例患者中有9例出现HV间期延长，且不受氨力农影响。10例患者在急性口服氨力农期间进行了动态心电图监测。室性早搏或室性心动过速的频率没有显著变化，尽管室性成对搏动的频率有轻微增加趋势。因此，氨力农可增强房室传导，在急性给药期间似乎没有明显的致心律失常潜力。
