Oeff M, Beck O A, Halilović E, Hochrein H
Dtsch Med Wochenschr. 1980 Oct 24;105(43):1497-501. doi: 10.1055/s-2008-1070899.
Nineteen patients in the acute stage of transmural myocardial infarction were given 20 mg nifedipine orally under haemodynamic control. Two groups were differentiated according to the original left ventricular filling pressure: group 1 pressure less than or equal to 15 mm Hg (n1 = 8), group 2 pressure > 15 mm Hg (n2 = 11). In both groups a significant drop in peripheral resistance and thus arterial mean pressure was found 1-2 hours after ingestion of nifedipine. in the compensated patients in group 1 it led to lowering of the left ventricular stroke-work index with virtually unchanged heart rate and constant cardiac index. The lower initial values for stroke-work index in the decompensated group 2 were not influenced by nifedipine. In the patients of group 2 a small but yet significant lowering of the left ventricular filling pressure was obtained with original values of 22.6 mm Hg on average. Thus the use of nifedipine in the acute phase of myocardial infarction leads to a more economical cardiac action in compensated patients. In decompensated cases the results do not deteriorate, and the tendency to reduction of left ventricular filling pressure may even result in a recompensation of the left ventricle.
19例透壁性心肌梗死急性期患者在血流动力学监测下口服20毫克硝苯地平。根据最初的左心室充盈压分为两组:1组压力小于或等于15毫米汞柱(n1 = 8),2组压力> 15毫米汞柱(n2 = 11)。两组在服用硝苯地平后1 - 2小时均出现外周阻力显著下降,进而动脉平均压下降。在1组代偿性患者中,这导致左心室每搏功指数降低,心率基本不变,心脏指数恒定。2组失代偿患者较低的初始每搏功指数值不受硝苯地平影响。在2组患者中,平均初始值为22.6毫米汞柱的左心室充盈压有小幅但显著的降低。因此,硝苯地平在心肌梗死急性期的应用使代偿性患者的心脏作用更经济。在失代偿情况下,结果不会恶化,左心室充盈压降低的趋势甚至可能导致左心室再代偿。