Thormann J, Kramer W, Schlepper M
Am Heart J. 1982 Dec;104(6):1294-302. doi: 10.1016/0002-8703(82)90159-4.
AR-L 115 has been shown to improve left ventricular (LV) pump function in patients with advanced congestive cardiomyopathy by the intravenous and oral routes. Since AR-L 115 effects on myocardial oxygen consumption (MVO2) and coronary blood flow (CSF) are unknown, the hemodynamic, myocardial metabolic, and ECG responses to AR-L 115 (2 mg/kg bolus) were monitored at 9-, 14-, and 9-minute intervals in seven patients with coronary disease, exhibiting ischemia during pacing stress only. Maximal responses occurred at the fourteenth minute after AR-L 115. There were (average) increases in cardiac index by 30%, heart rate by 19%, CSF by 39%, MVO2 by 34%, and LV dp/dt max by 27%. There were (average) decreases in peak LV systolic pressure by 13%, LV end-diastolic pressure by 42%, systemic vascular resistance by 34%, and in coronary vascular resistance by 37%. All changes were significant (p less than 0.05). Myocardial lactate extraction, stroke work index, and stroke index remained unchanged (p greater than 0.05). The modest increase in MVO2 is possibly explained by the increase in contractility being partially offset by reductions in LV preload and afterload. AR-L 115-improved LV pump function was accompanied by moderate increases in MVO2 and CSF but without evidence of myocardial ischemia.
AR-L 115已被证明通过静脉和口服途径可改善晚期充血性心肌病患者的左心室（LV）泵功能。由于AR-L 115对心肌耗氧量（MVO2）和冠状动脉血流量（CSF）的影响尚不清楚，因此在7例仅在起搏应激时出现缺血的冠心病患者中，每隔9分钟、14分钟和9分钟监测AR-L 115（2mg/kg推注）引起的血流动力学、心肌代谢和心电图反应。AR-L 115给药后第14分钟出现最大反应。心指数平均增加30%，心率增加19%，CSF增加39%，MVO2增加34%，LV dp/dt max增加27%。左心室收缩压峰值平均降低13%，左心室舒张末期压力降低42%，体循环血管阻力降低34%，冠状动脉血管阻力降低37%。所有变化均具有显著性（p<0.05）。心肌乳酸摄取、每搏功指数和每搏指数保持不变（p>0.05）。MVO2的适度增加可能是由于收缩力增加部分被左心室前负荷和后负荷降低所抵消。AR-L 115改善左心室泵功能的同时，MVO2和CSF适度增加，但无心肌缺血证据。
