von Bibra H, Gibson D G, Nityanandan K
Br Heart J. 1980 Mar;43(3):293-300. doi: 10.1136/hrt.43.3.293.
To assess the acute and chronic effects of propranolol on left ventricular wall motion, simultaneous, echo-, apex-, and phonocardiograms were recorded in 10 normal subjects and in 16 patients with ischaemic heart disease, nine with co-ordinate (group A) and seven with incoordinate (group B) contraction in the control site. Records were made after 0.1 mg/kg intravenous or oral therapeutic dose for one week. In all, propranolol caused small reductions in heart rate and peak VCF. In normal subjects, intravenous and oral propranolol caused rate-related increases in the intervals Q to A2, Q to minimum dimension, and Q to mitral valve opening. The effects were different in patients with ischaemic heart disease. In group A, inward wall movement ceased 80 ms early, and this was not attributable to a change in heart rate. Diastolic events were unaltered. In group B, minimum dimension already occurred early. Propranolol did not alter systolic events further, but increased delay in mitral valve opening, 'O' point, prolonged isovolumic relaxation, reduced peak rate of dimension increase, and aggravated incoordinate relaxation. It is concluded that the effects of propranolol in patients with ischaemic heart disease are modified in a manner that cannot be predicted from observations made in normal subjects. It also appears that complex drug effects can be assessed in man from the measurement of time intervals derived from multiple non-invasive techniques.
为评估普萘洛尔对左心室壁运动的急慢性影响，对10名正常受试者和16名缺血性心脏病患者同时记录了超声心动图、心尖搏动图和心音图，其中9名对照部位收缩协调（A组），7名收缩不协调（B组）。在静脉注射或口服0.1mg/kg治疗剂量一周后进行记录。总体而言，普萘洛尔使心率和峰值心室周径缩短速率（VCF）略有降低。在正常受试者中，静脉注射和口服普萘洛尔使Q至A2间期、Q至最小内径间期以及Q至二尖瓣开放间期出现与心率相关的延长。缺血性心脏病患者的情况有所不同。在A组中，室壁内向运动提前80毫秒停止，这并非心率变化所致。舒张期事件未改变。在B组中，最小内径出现时间本就提前。普萘洛尔未进一步改变收缩期事件，但增加了二尖瓣开放延迟、“O”点、延长了等容舒张期、降低了内径增加峰值速率，并加重了不协调舒张。结论是，普萘洛尔对缺血性心脏病患者的影响与在正常受试者中观察到的情况不同，无法据此预测。此外，似乎可以通过测量多种非侵入性技术得出的时间间期来评估人体中的复杂药物效应。
