钙拮抗剂硝苯地平、β受体阻滞剂醋丁洛尔和普萘洛尔及其联合应用对人体电生理参数影响的比较研究
[Comparative study of the effect of the calcium antagonist nifedipine, the beta receptor blockers acebutolol and propranolol and their combination on electrophysiologic parameters in the human].
作者信息
Vey G, Wiese K H, Schramm A, Walter J
出版信息
Z Kardiol. 1984 Feb;73(2):101-5.
It is well known that in the isolated atrium, nifedipine, verapamil and diltiazem slow down the spontaneous frequency and conduction velocity in the sinus- and in the atrioventricular node. Using therapeutic doses in man, we studied the influence of the calcium-antagonist nifedipine, the beta-blockers acebutolol and propranolol and a combination of these on sinus-node parameters (spontaneous cycle length AA, sinus-node recovery time SNRT, corrected sinus-node recovery time CSNRT, sinoatrial conduction time SACT), and on the intracardiac conduction time (PA-, AH-, HV-interval). Both beta-blockers slowed the spontaneous frequency of depolarization of the sinus-node, but lengthened sinus-node recovery time and sinoatrial conduction time (acebutolol: AA + 6% n.s.; SNRT +5% n.s.; CSNRT +2% n.s.; SACT +33% s.; propranolol: AA +9% n.s.; SNRT +15% s.; CSNRT +37% n.s.; SACT +32% n.s.). Simultaneously PA-, AH and HV-interval lengthened (acebutolol: PA +16% n.s.; AH +7% s.; HV +15% s.; propranolol: PA +19% n.s.; AH +16% s.; HV +9% s.). Nifedipine caused essentially no change in sinus-node parameters nor in intracardiac conduction time in man (AA -11% s.; SNRT -12% s.; CSNRT -7% n.s.; SACT +35% n.s.; PA +4% n.s., AH -2% n.s.; HV +5% n.s.). This is in contrast to results obtained in the isolated atrium, and is different from other calcium-antagonists such as verapamil, gallopamil and diltiazem. The effect of acebutololinduced beta-blockade is not intensified by nifedipine (AA -3% n.s.; SNRT -6% s.; CSNRT -12% s.; SACT -19% n.s.; PA -5% n.s.; AH +3% n.s.; HV +9% n.s.).
众所周知，在离体心房中，硝苯地平、维拉帕米和地尔硫䓬可减慢窦房结和房室结的自发频率及传导速度。我们使用人体治疗剂量，研究了钙拮抗剂硝苯地平、β受体阻滞剂醋丁洛尔和普萘洛尔以及它们的组合对窦房结参数（自发周期长度AA、窦房结恢复时间SNRT、校正窦房结恢复时间CSNRT、窦房传导时间SACT）以及心内传导时间（PA间期、AH间期、HV间期）的影响。两种β受体阻滞剂均减慢了窦房结的自发去极化频率，但延长了窦房结恢复时间和窦房传导时间（醋丁洛尔：AA增加6%，无统计学意义；SNRT增加5%，有统计学意义；CSNRT增加2%，无统计学意义；SACT增加33%，有统计学意义；普萘洛尔：AA增加9%，无统计学意义；SNRT增加15%，有统计学意义；CSNRT增加37%，无统计学意义；SACT增加32%，有统计学意义）。同时，PA间期、AH间期和HV间期延长（醋丁洛尔：PA增加16%，无统计学意义；AH增加7%，有统计学意义；HV增加15%，有统计学意义；普萘洛尔：PA增加19%，无统计学意义；AH增加16%，有统计学意义；HV增加9%，有统计学意义）。硝苯地平对人体窦房结参数和心内传导时间基本无影响（AA减少11%，有统计学意义；SNRT减少12%，有统计学意义；CSNRT减少7%，无统计学意义；SACT增加35%，无统计学意义；PA增加4%，无统计学意义，AH减少2%，无统计学意义；HV增加5%，无统计学意义）。这与在离体心房中获得的结果相反，且与维拉帕米、加洛帕米和地尔硫䓬等其他钙拮抗剂不同。硝苯地平不会增强醋丁洛尔诱导的β受体阻滞作用（AA减少3%，无统计学意义；SNRT减少6%，有统计学意义；CSNRT减少12%，有统计学意义；SACT减少19%，无统计学意义；PA减少5%，无统计学意义；AH增加3%，无统计学意义；HV增加9%，无统计学意义）。
Zotero 插件