Petrella R J, Nichol P M, Cunningham D A, Paterson D H
Faculty of Medicine, University of Western Ontario, London.
Can J Cardiol. 1994 Dec;10(10):973-81.
To study the effect of verapamil slow release (SR) upon left ventricular diastolic function and exercise capacity in newly diagnosed older hypertensive subjects compared with normotensive elderly and young controls.
Cross-sectional prospective trial.
Doppler echocardiography at rest and graded maximal exercise testing (with breath-by-breath gas analysis) before and 4 h after administration of oral verapamil SR 240 mg, and before and after 12 weeks of daily medication.
Verapamil administration normalized resting blood pressure in the older hypertensive group, but did not alter blood pressure in older normotensive or young groups. Resting heart rate was not altered in any of the groups. Both the older hypertensive and normotensive groups showed improvement in measures of diastolic filling after verapamil ingestion. Specifically, the older hypertensive group showed significantly faster isovolumic relaxation time (IVRT). In the older normotensive group IVRT was not changed, but the E:A ratio (the ratio of early to late peak transmitral flow velocity) was increased after verapamil. No differences were observed between the effects of verapamil after acute ingestion (4 h) or with chronic use (12 weeks) in any of the variables measured. In the younger group diastolic filling was not altered after verapamil ingestion. In both the elderly normotensive and hypertensive groups maximum oxygen consumption was significantly improved following verapamil ingestion. Again, no differences were observed between 4 h and 12 weeks. In the younger subjects exercise performance was not changed after verapamil ingestion.
Verapamil SR improved left ventricular diastolic function and exercise performance in hypertensive and normotensive elderly individuals. Verapamil normalized blood pressure in the hypertensive subjects, but did not alter blood pressure in the normotensive elderly or younger subjects.
研究与血压正常的老年人及年轻对照组相比，缓释维拉帕米对新诊断的老年高血压患者左心室舒张功能和运动能力的影响。
横断面前瞻性试验。
口服240毫克缓释维拉帕米前、服药后4小时、每日服药12周前后，分别进行静息状态下的多普勒超声心动图检查以及分级最大运动试验（逐次呼吸气体分析）。
服用维拉帕米使老年高血压组静息血压恢复正常，但未改变老年血压正常组或年轻组的血压。所有组的静息心率均未改变。老年高血压组和血压正常组在服用维拉帕米后舒张期充盈指标均有所改善。具体而言，老年高血压组等容舒张时间（IVRT）显著加快。老年血压正常组IVRT未改变，但服用维拉帕米后E:A比值（二尖瓣血流速度早期与晚期峰值之比）增加。在急性摄入（4小时）或长期使用（12周）维拉帕米后，所测任何变量的效应均未观察到差异。年轻组服用维拉帕米后舒张期充盈未改变。老年血压正常组和高血压组服用维拉帕米后最大摄氧量均显著改善。同样，4小时和12周之间未观察到差异。年轻受试者服用维拉帕米后运动表现未改变。
缓释维拉帕米改善了高血压和血压正常的老年个体的左心室舒张功能和运动表现。维拉帕米使高血压受试者血压恢复正常，但未改变血压正常的老年受试者或年轻受试者的血压。
