Sadick N N, Tan A T, Fletcher P J, Morris J, Kelly D T
Circulation. 1982 Sep;66(3):574-9. doi: 10.1161/01.cir.66.3.574.
In 18 patients with stable effort angina, verapamil, 80 mg four times daily, was compared with propranolol, 80 mg four times daily, in a double-blind, placebo-controlled trial to assess the effects on anginal threshold, exercise capacity and left ventricular function measured by gated equilibrium blood pool scanning. Both propranolol and verapamil improved exercise capacity (placebo 424 +/- 135 W-min; propranolol 513 +/- 168 W-min, p less than 0.01; verapamil 545 +/- 215 W-min, p less than 0.005) and prolonged the time to 1 mm of ST depression (placebo 4.5 +/- 1.3 minutes; propranolol 7.4 +/- 1.4 minutes, p less than 0.005; verapamil 6.6 +/- 1.9 minutes, p less than 0.005). At rest, the mean left ventricular ejection fraction did not change significantly during drug therapy (placebo 57 +/- 13%, propranolol 55 +/- 12%, verapamil 55 +/- 13%). While taking placebo, all 18 patients had a decrease in exercise ejection fraction. In contrast, 12 patients taking propranolol and 14 patients taking verapamil had a 5% or greater increase in ejection fraction during exercise. Verapamil is an effective primary therapy and a satisfactory alternative to propranolol in patients with stable effort angina.
在一项双盲、安慰剂对照试验中，对18例稳定型劳力性心绞痛患者进行了研究，比较每日4次、每次80mg维拉帕米与每日4次、每次80mg普萘洛尔的疗效，以评估其对心绞痛阈值、运动能力和通过门控平衡血池扫描测量的左心室功能的影响。普萘洛尔和维拉帕米均能提高运动能力（安慰剂组424±135W-分钟；普萘洛尔组513±168W-分钟，p<0.01；维拉帕米组545±215W-分钟，p<0.005），并延长ST段压低1mm的时间（安慰剂组4.5±1.3分钟；普萘洛尔组7.4±1.4分钟，p<0.005；维拉帕米组6.6±1.9分钟，p<0.005）。静息时，药物治疗期间平均左心室射血分数无显著变化（安慰剂组57±13%，普萘洛尔组55±12%，维拉帕米组55±13%）。服用安慰剂时，所有18例患者运动时射血分数均下降。相比之下，12例服用普萘洛尔的患者和1例服用维拉帕米的患者运动时射血分数增加5%或更多。维拉帕米是稳定型劳力性心绞痛患者的一种有效初始治疗药物，也是普萘洛尔的一种令人满意的替代药物。
