Trobaugh G B, Kudenchuk P J, Greene H L, Tutt R C, Kingston E, Gorham J R, Gross B W, Graham E L, Sears G K, Werner J A
Am J Cardiol. 1984 Dec 1;54(10):1263-6. doi: 10.1016/s0002-9149(84)80077-6.
Myocardial size and contractility were measured by gated radionuclide ventriculography in 70 patients before and a mean of 66 days after beginning amiodarone therapy. The mean dose of amiodarone at the time of the second study was 481 mg. The mean left ventricular (LV) ejection fraction (EF) increased slightly, from 40% to 43% (p = 0.001). The mean right ventricular EF remained unchanged (38% to 39%, difference not significant [NS]). The LV end-diastolic volume (count-based method) increased by 9% (p = 0.01), but no change could be demonstrated for end-systolic volume (4%, NS). The LV stroke volume increased 19% (p = 0.001), but cardiac output remained unchanged (5%, NS) because the heart rate decreased by 9 beats/min (p = 0.001). The right ventricular end-diastolic volume increased by 12% (p = 0.01) and end-systolic volume increased by 11% (p = 0.03). Stroke volume increased by 18% (p = 0.005). There was no significant correlation between the change in LVEF and the pre-amiodarone LVEF, the time interval between studies, or with indexes of amiodarone effect (change in heart rate, QRS, QTc, TSH, amiodarone dosage). In 5 patients (7%), LVEF decreased significantly, requiring discontinuation of amiodarone therapy in 1 patient. At the time of the second study congestive heart failure was manifest in 19%, and there was a trend suggesting that congestive heart failure was more likely if the initial LVEF was less than or equal to 35% (p = 0.10). Thus, amiodarone may rarely adversely affect contractility, although myocardial contractility is typically unchanged. There is an associated small increase in the size of both ventricles.
在70例患者中，在开始胺碘酮治疗前及治疗后平均66天，通过门控放射性核素心室造影测量心肌大小和收缩力。第二次研究时胺碘酮的平均剂量为481毫克。左心室（LV）射血分数（EF）均值略有增加，从40%增至43%（p = 0.001）。右心室EF均值保持不变（38%至39%，差异无统计学意义[NS]）。左心室舒张末期容积（基于计数法）增加了9%（p = 0.01），但收缩末期容积无变化（4%，NS）。左心室每搏输出量增加了19%（p = 0.001），但心输出量保持不变（5%，NS），因为心率降低了9次/分钟（p = 0.001）。右心室舒张末期容积增加了12%（p = 0.01），收缩末期容积增加了11%（p = 0.03）。每搏输出量增加了18%（p = 0.005）。左心室射血分数的变化与胺碘酮治疗前的左心室射血分数、两次研究之间的时间间隔或胺碘酮效应指标（心率、QRS、QTc、促甲状腺激素、胺碘酮剂量的变化）之间无显著相关性。5例患者（7%）左心室射血分数显著降低，其中1例患者需要停用胺碘酮治疗。第二次研究时，19%的患者出现充血性心力衰竭，并且有一种趋势表明，如果初始左心室射血分数小于或等于35%，则更有可能发生充血性心力衰竭（p = 0.10）。因此，胺碘酮很少会对收缩力产生不利影响，尽管心肌收缩力通常无变化。两个心室的大小会有相关的小幅增加。
