Foresti A, Massari F M, Moglia F, Lotto A
G Ital Cardiol. 1982;12(11):767-74.
To assess the hemodynamic effects of Clonidine in hypertensive patients (pts) with an acute myocardial infarction (AMI), we administered the drug to 12 such patients either in a single bolus (75--150 micrograms in 5 min - 8 pts) or by continuous infusion (0.4--5 micrograms/min - 4 pts). Hemodynamic measurements were obtained by means of a Swan-Ganz thermodilution catheter, before and 60 min after the administration of the drug. Clonidine did not significantly affected Heart Rate (from 80.5 +/- 3.9 to 78.4 +/- 5.9 beats/min), Mean Pulmonary Arterial Pressure (from 18.6 +/- 1.7 to 15.1 +/- 1 mmHg), Mean Pulmonary Wedge Pressure (from 12.5 +/- 1.1 to 10.6 +/- 0.7 mmHg), central Venous Pressure (from 4 +/- 0.8 to 3 +/- 0.9 mmHg), Cardiac Index (from 2.6 +/- 0.07 to 2.6 +/- 0.7 L/min/m2), Stroke Volume (from 65.2 +/- 2.8 to 68.5 +/- 5.5 ml/b). Conversely Mean Arterial Pressure fell significantly from 127 +/- 3.1 to 96.2 +/- 7.2 mmHg (P less than 0.001). Left Ventricular Systolic Work Index was reduced from 62.3 +/- 3.3 to 50.4 +/- 4.4 gm/beats/m2 (P less than 0.025), Total Systemic Resistances from 1888 +/- 50 to 1412 +/- 117 dyne sec cm-5 (P less than 0.005) and Tension Time Index from 3536 +/- 495 to 2389 +/- 385 x 10(3) mmHg x sec/min (p less than 0.05). Clonidine is a safe and useful drug to obtain a fall of high blood pressure often complicating AMI, without depressing left ventricular performance, as suggested by no significant changes of CI, WP and LVSWI. The reduction of TTI suggests a beneficial effect on the balance between myocardial oxygen delivery and demand. Clonidine is a hypotensive drug which can be safely used in patients with AMI, without depressing the left ventricular performance.
为评估可乐定对急性心肌梗死（AMI）高血压患者的血流动力学影响，我们对12例此类患者给药，其中8例患者在5分钟内单次推注（75 - 150微克），4例患者持续输注（0.4 - 5微克/分钟）。在给药前及给药后60分钟，通过Swan - Ganz热稀释导管进行血流动力学测量。可乐定对心率（从80.5±3.9次/分钟降至78.4±5.9次/分钟）、平均肺动脉压（从18.6±1.7降至15.1±1mmHg）、平均肺楔压（从12.5±1.1降至10.6±0.7mmHg）、中心静脉压（从4±0.8降至3±0.9mmHg）、心脏指数（从2.6±0.07升至2.6±0.7L/分钟/平方米）、每搏量（从65.2±2.8升至68.5±5.5毫升/搏）均无显著影响。相反，平均动脉压从127±3.1显著降至96.2±7.2mmHg（P＜0.001）。左心室收缩作功指数从62.3±3.3降至50.4±4.4克/搏/平方米（P＜0.025），总体循环阻力从1888±50降至1412±117达因·秒·厘米⁻⁵（P＜0.005），张力 - 时间指数从3536±495降至2389±385×10³mmHg×秒/分钟（P＜0.05）。如心脏指数、肺楔压和左心室收缩作功指数无显著变化所示，可乐定是一种安全有效的药物，可降低常使AMI复杂化的高血压，而不降低左心室功能。张力 - 时间指数的降低表明对心肌氧供与需求平衡有有益作用。可乐定是一种降压药物，可安全用于AMI患者，而不降低左心室功能。
