Leclercq J F, Rosengarten M D, Kural S, Attuel P, Coumel P
Eur J Cardiol. 1981;12(6):367-75.
The authors compare the effects of beta-blockers without intrinsic sympathetic activity (ISA) (propranolol, 160 mg/day), moderate ISA (acebutolol, 800 mg/day) and high ISA (pindolol, 20 mg/day). The sinus rate decreases more with propranolol than with acebutolol, during the day (P less than 0.01) and during the night (P less than 0.001), whereas pindolol does not change the daylight rate and increases the nighttime rate (P less than 0.001). The ventricular rate during atrial fibrillation (AV nodal transmission) is modified as is sinus rate. There is no significant difference between propranolol and acebutolol, and a highly significant difference between pindolol and propranolol (P less than 0.001) or acebutolol (P less than 0.01). Moreover, the eurythmic effect of beta-blockers, making RR intervals more regular, is maximal with propranolol and minimal with pindolol, as judged on RR interval histograms. The ISA of the beta-blockers is of major importance for the clinical use of these drugs, and in the case of SA or AV node dysfunction ISA can be useful, but it can obscure the beneficial effects of beta-blocking therapy.
作者比较了无内在交感活性（ISA）的β受体阻滞剂（普萘洛尔，160毫克/天）、中度ISA（醋丁洛尔，800毫克/天）和高度ISA（吲哚洛尔，20毫克/天）的效果。白天（P<0.01）和夜间（P<0.001），普萘洛尔使窦性心率降低的幅度大于醋丁洛尔，而吲哚洛尔不改变白天心率，反而增加夜间心率（P<0.001）。房颤时的心室率（房室结传导）也如窦性心率一样受到影响。普萘洛尔和醋丁洛尔之间无显著差异，而吲哚洛尔与普萘洛尔（P<0.001）或醋丁洛尔（P<0.01）之间存在高度显著差异。此外，根据RR间期直方图判断，β受体阻滞剂使RR间期更规律的整律作用在普萘洛尔时最大，在吲哚洛尔时最小。β受体阻滞剂的ISA对这些药物的临床应用至关重要，在窦房结或房室结功能障碍的情况下，ISA可能有用，但它可能会掩盖β受体阻滞剂治疗的有益效果。
