Kosinski E J, Albin J B, Young E, Lewis S M, LeLand O S
J Am Coll Cardiol. 1984 Sep;4(3):565-70. doi: 10.1016/s0735-1097(84)80103-5.
Amiodarone is a potent antiarrhythmic agent that is effective in controlling both atrial and ventricular arrhythmias. Recently, intravenous administration was demonstrated to be effective in the acute management of rhythm disorders and, in addition, appeared to shorten the loading period normally required for oral drug administration. This investigation examined the hemodynamic effects of amiodarone after both acute intravenous bolus and continuous intravenous administration. Patients with a left ventricular ejection fraction greater than 0.35 experienced improved cardiac performance due to both acute and chronic peripheral vasodilation. However, patients with a lower ejection fraction developed a 20% decrease in cardiac index and clinically significant elevation of right heart pressures after acute bolus administration; these changes were variably compensated for by peripheral vasodilation when the drug was administered intravenously over 3 to 5 days continuously. Therefore, intravenous amiodarone can result in significant impairment of left ventricular performance in patients with preexisting left ventricular dysfunction.
胺碘酮是一种强效抗心律失常药物，对控制房性和室性心律失常均有效。最近的研究表明，静脉给药在心律失常的急性处理中有效，此外，似乎还能缩短通常口服药物所需的负荷期。本研究考察了静脉推注胺碘酮及持续静脉输注胺碘酮后的血流动力学效应。左心室射血分数大于0.35的患者，由于急性和慢性外周血管扩张，心脏功能得到改善。然而，射血分数较低的患者在静脉推注胺碘酮后，心脏指数下降20%，右心压力出现具有临床意义的升高；当药物持续静脉输注3至5天时，这些变化会因外周血管扩张而得到不同程度的代偿。因此，静脉应用胺碘酮可导致已有左心室功能障碍的患者左心室功能显著受损。
