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新型强心剂TA-064的作用:压力-容积关系及在线心肌氧消耗的系列计算机辅助分析

[Effects of the new cardiotonic agent TA-064: serial computer-assisted analyses of pressure-volume relations and online myocardial 02 consumption].

作者信息

Thormann J, Kramer W, Kindler M, Neuss H, Bahawar H, Schlepper M

出版信息

Z Kardiol. 1984 Dec;73(12):772-85.

PMID:6523977
Abstract

UNLABELLED

According to investigations conducted in Japan, TA-064 is a new cardiotonic agent, which is also effective orally. We analyzed computer-assisted alterations of pressure-volume relations serially and of MVO2 online (Bretschneider) during TA-064 influence in 16 patients with congestive cardiomyopathy: LV-function of 7 patients was only moderately decreased (group A) and in 9 patients massively (group B).

RESULTS

  1. TA-064, 8 micrograms/kg/min, i.v. had positive inotropic effects in both groups and induced mean maximal delta% changes at about the 5th minute of infusion as follows: LVSWI + 65% and 47%; DP/DTmax + 61% and 59%; LV-efficiency + 62% and 53%; MVO2 + 31% and + 11% (p less than 0.05). 2) TA-064, 20 mg p.o. induced serum levels (A: 23.8 +/- 12 and B: 26.4 +/- 20 ng/ml) corresponding to the effects with the dosages 1-2 micrograms/kg/min, i.v. (p greater than 0.05), thus implying that significant changes in LV-function require higher p.o. dosages. 3) TA-064 i.v. on the 6th day of exposure to the medication produced less LV-function improvement than on day 1 (p greater than 0.05).

CONCLUSIONS

In both groups A and B TA-064 improves LV-function primarily via increased contractility, without toxic side effects. For a more complex definition of the efficiency and mechanism of cardiotonic agents, the validity and importance of using on-line MVO2 assessment and analysis of serial pressure-volume relations is stressed.

摘要

未标记

根据在日本进行的调查,TA - 064是一种新型强心剂,口服也有效。我们连续分析了16例充血性心肌病患者在TA - 064作用期间压力 - 容积关系的计算机辅助变化以及在线(布雷tschneider)的MVO2:7例患者的左心室功能仅中度下降(A组),9例患者严重下降(B组)。

结果

1)静脉注射TA - 064,8微克/千克/分钟,两组均有正性肌力作用,在输注约第5分钟时诱导的平均最大δ%变化如下:左心室每搏作功指数(LVSWI)分别增加65%和47%;最大dp/dt分别增加61%和59%;左心室效率分别增加62%和53%;MVO2分别增加31%和11%(p小于0.05)。2)口服TA - 064,20毫克,诱导的血清水平(A组:23.8±12和B组:26.4±20纳克/毫升)与静脉注射剂量1 - 2微克/千克/分钟的效果相当(p大于0.05),这意味着左心室功能的显著变化需要更高的口服剂量。3)在用药第6天静脉注射TA - 064产生的左心室功能改善比第1天少(p大于0.05)。

结论

在A组和B组中,TA - 064主要通过增加收缩力改善左心室功能,无毒性副作用。为了更复杂地定义强心剂的效率和机制,强调了使用在线MVO2评估和连续压力 - 容积关系分析的有效性和重要性。

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