Betocchi S, Cannon R O, Watson R M, Bonow R O, Ostrow H G, Epstein S E, Rosing D R
Circulation. 1985 Nov;72(5):1001-7. doi: 10.1161/01.cir.72.5.1001.
The hemodynamic effects of sublingual nifedipine were examined in 36 patients with hypertrophic cardiomyopathy. Twenty-one patients were initially given 20 mg and 15 patients were given 10 mg of the drug; 30 min after this first dose 26 patients received 10 mg and one patient 20 mg as a second dose. Hemodynamic findings in patients who received different doses of the drug were similar. Peak effects included an increase in heart rate from 79 +/- 12 to 91 +/- 14 (mean +/- 1 SD) beats/min (p less than .01), and a decrease in mean blood pressure from 89 +/- 12 to 77 +/- 10 mm Hg (p less than .01). Cardiac index increased after nifedipine (2.8 +/- 0.6 to 3.3 +/- 0.8 liters/min/m2; p less than .01); stroke volume index, however, did not change (36 +/- 7 to 36 +/- 8 ml/beat/m2; NS). Peripheral vascular resistance index fell significantly from 822 +/- 261 to 610 +/- 197 dynes X sec X cm-5 (p less than .01). Overall, left ventricular outflow tract gradient (LVOTG) did not change in patients with significant (greater than or equal to 30 mm Hg) basal LVOTG (75 +/- 22 to 83 +/- 22 mm Hg; NS), but it increased significantly in those six patients in whom peripheral vascular resistance fell by 25% or more (73 +/- 28 to 99 +/- 22 mm Hg; p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)
对36例肥厚型心肌病患者进行了舌下含服硝苯地平的血流动力学效应研究。21例患者初始给予20mg药物，15例患者给予10mg药物；首剂给药30分钟后，26例患者接受10mg药物，1例患者接受20mg药物作为第二剂。接受不同剂量药物的患者血流动力学结果相似。峰值效应包括心率从79±12次/分钟增加到91±14次/分钟（平均值±1标准差）（p<0.01），平均血压从89±12mmHg降至77±10mmHg（p<0.01）。硝苯地平治疗后心脏指数增加（从2.8±0.6升至3.3±0.8升/分钟/平方米；p<0.01）；然而，每搏量指数未改变（从36±7降至36±8毫升/次/平方米；无显著性差异）。外周血管阻力指数从822±261显著降至610±197达因×秒×厘米-5（p<0.01）。总体而言，基础左心室流出道压差（LVOTG）显著（≥30mmHg）的患者左心室流出道压差未改变（从75±22降至83±22mmHg；无显著性差异），但在6例外周血管阻力下降25%或更多的患者中显著增加（从73±28升至99±22mmHg；p<0.05）。（摘要截选至250字）
