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[一种新型正性肌力药物(AR-L 115 BS)对缺血性和非缺血性心肌病的血流动力学影响]

[Hemodynamic effects of a new positive inotropic agent (AR-L 115 BS) in ischemic and nonischemic myocardiopathies].

作者信息

Colle J P, Ohayon J, Ledain L, Besse P

出版信息

Arch Mal Coeur Vaiss. 1984 Dec;77(13):1532-9.

PMID:6440503
Abstract

AR-L 115 BS is an imidazo-pyridine derivative with a positive inotropic action associated with peripheral and coronary vasodilatory properties. The effects of intravenous administration (a bolus of 0,45 mg/kg/min) were studied in 19 patients in functional class III of the NYHA classification in the absence of any previous drug therapy. Twelve patients had a primary myocardiopathy and the other 7 had coronary artery disease with akinetic anterior walls. A Swan-Ganz thermodilution catheter and a Millar microtransducer were used to measure pressures (pulmonary artery, left ventricular, aorta) and cardiac output under basal conditions and then every 2 minutes during intravenous administration of AR-L 115 BS. Left ventriculography in the 30 degrees RAO plane was performed under basal conditions and at the end of the investigation to measure volumes, ejection fraction, volumic compliance and segmental wall motion by the Stanford method. A stable concentration of circulating AR-L 115 BS was obtained (1 500 ng/ml). The positive inotropic action of the drug was responsible for a significant increase of all ejectional indices (cardiac and systolic index X 24 p. 100, p less than 0.01; ejection fraction +14 p. 100, p less than 0.01), of all indices of isometric contractility (dP/dt max +25 p. 100, velocity of contractile elements +35 p. 100, V max +30 p. 100 (p less than 0.01) and of the velocity of circumferential fibre shortening (+65 p. 100, p less than 0.001). All segmental shortening was improved.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

AR-L 115 BS是一种咪唑并吡啶衍生物,具有正性肌力作用,并伴有外周血管和冠状动脉扩张特性。在19例纽约心脏协会(NYHA)心功能分级为III级且未接受过任何药物治疗的患者中,研究了静脉给药(0.45 mg/kg/min推注)的效果。12例患者患有原发性心肌病,另外7例患有冠状动脉疾病且前壁运动减弱。使用Swan-Ganz热稀释导管和Millar微型换能器在基础状态下测量压力(肺动脉、左心室、主动脉)和心输出量,然后在静脉输注AR-L 115 BS期间每2分钟测量一次。在基础状态下和研究结束时,在右前斜30度平面进行左心室造影,通过斯坦福方法测量容积、射血分数、容积顺应性和节段性室壁运动。获得了稳定的循环AR-L 115 BS浓度(1500 ng/ml)。该药物的正性肌力作用导致所有射血指标(心脏指数和收缩指数增加24%,p<0.01;射血分数增加14%,p<0.01)、所有等长收缩指标(最大dp/dt增加25%,收缩成分速度增加35%,Vmax增加30%,p<0.01)以及圆周纤维缩短速度(增加65%,p<0.001)均显著增加。所有节段性缩短均得到改善。(摘要截短于250字)

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