Landmark K, Sire S, Thaulow E, Amlie J P, Nitter-Hauge S
Br Heart J. 1982 Jul;48(1):19-26. doi: 10.1136/hrt.48.1.19.
The haemodynamic effects of nifedipine, propranolol, and the combined administration of the two drugs were studied in 12 patients with hypertrophic obstructive cardiomyopathy. The combined administration of nifedipine and propranolol appeared to be superior to that of nifedipine alone. The spontaneous heart rate was reduced in most cases after nifedipine plus propranolol, and at atrial pacing the following results were obtained: left ventricular peak systolic pressure was reduced from 200 +/- 39 to 157 +/- 30 mmHg; a positive correlation was found between the pre-drug left ventricular end-diastolic pressure and the magnitude of reduction in left ventricular end-diastolic pressure; systolic blood pressure was reduced from 125 +/- 31 to 111 +/- 27 mmHg, and total peripheral resistance was reduced from 1403 +/- 307 to 1160 +/- 209 dyne s-1 cm-5. The combined administration reduced the resting left ventricular outflow gradient from 76 +/- 19 to 45 +/- 26 mmHg, while cardiac index was left unchanged. The effects on mean pulmonary arteriolar resistance and mean pulmonary arteriolar resistance and mean pulmonary capillary venous pressure were in most cases slight and insignificant. The results indicate an improved haemodynamic condition in patients with hypertrophic obstructive cardiomyopathy after the combined administration of nifedipine and propranolol: a treatment that might provide a new and useful alternative to already existing medication.
对12例肥厚性梗阻性心肌病患者研究了硝苯地平、普萘洛尔以及两药联合应用的血流动力学效应。硝苯地平和普萘洛尔联合应用似乎优于单独使用硝苯地平。硝苯地平加普萘洛尔治疗后多数病例的静息心率降低，心房起搏时获得以下结果：左心室收缩压峰值从200±39mmHg降至157±30mmHg；用药前左心室舒张末期压力与左心室舒张末期压力降低幅度之间呈正相关；收缩压从125±31mmHg降至111±27mmHg，总外周阻力从1403±307达因·秒·厘米⁻⁵降至1160±209达因·秒·厘米⁻⁵。联合用药使静息左心室流出道压差从76±19mmHg降至45±26mmHg，而心脏指数未变。多数情况下，联合用药对平均肺动脉阻力、平均肺毛细血管静脉压的影响轻微且无统计学意义。结果表明，硝苯地平和普萘洛尔联合应用后肥厚性梗阻性心肌病患者的血流动力学状况得到改善：这种治疗方法可能为现有药物治疗提供一种新的、有用的替代方案。
