Gürlek A, Erol C, Basesme E
Cardiology Department, Faculty of Medicine, Ankara University, Turkey.
Int J Cardiol. 1994 Mar 1;43(3):315-8. doi: 10.1016/0167-5273(94)90212-7.
In this study 24-h Holter electrocardiographic recordings were used to measure the effects of an angiotensin converting enzyme inhibitor, enalapril given for 4 weeks, on the frequency of cardiac arrhythmias in 24 patients (14 patients had enalapril, 30 patients had placebo) with congestive heart failure (New York Heart Association Functional Class 3) receiving maintenance therapy with digoxin and furosemide. Although the placebo group had no change in the frequence of arrhythmias, enalapril-treated patients showed significant decrease in the frequency of premature ventricular complexes couplet, bigemine VPS and ventricular tachycardia. Moreover, it was observed that six cases of atrial fibrillation returned to sinus rhythm. During enalapril treatment, some patients experienced increased serum potassium levels, but there was no change in serum digoxin levels. We also observed echocardiographic improvement in left ventricular function as well as clinical symptoms of congestive heart failure. Finally we observed that there was an antiarrhythmic effect of enalapril in congestive heart failure. We thought that the antiarrhythmic effect of enalapril in congestive heart failure was probably due to hemodynamic improvement.
在本研究中，使用24小时动态心电图记录来测量给予4周的血管紧张素转换酶抑制剂依那普利对24例充血性心力衰竭（纽约心脏协会心功能分级3级）患者心律失常频率的影响，这些患者接受地高辛和呋塞米维持治疗（14例患者服用依那普利，30例患者服用安慰剂）。尽管安慰剂组心律失常频率没有变化，但接受依那普利治疗的患者室性早搏成对、室性早搏二联律和室性心动过速的频率显著降低。此外，观察到6例心房颤动恢复为窦性心律。在依那普利治疗期间，一些患者血清钾水平升高，但血清地高辛水平没有变化。我们还观察到左心室功能的超声心动图改善以及充血性心力衰竭的临床症状改善。最后我们观察到依那普利对充血性心力衰竭有抗心律失常作用。我们认为依那普利在充血性心力衰竭中的抗心律失常作用可能是由于血流动力学改善。
