Spahn D R, Frasco P E, White W D, Smith L R, McRae R L, Leone B J
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710.
J Am Coll Cardiol. 1993 Mar 1;21(3):809-21. doi: 10.1016/0735-1097(93)90115-h.
The aim of this study was to determine whether esmolol, an ultrashort-acting beta-adrenergic antagonist, possesses cardioprotective properties unrelated to a concomitant decrease in heart rate.
Previous studies have demonstrated beneficial effects of beta-adrenergic blocking agents with unchanged heart rates.
The effect of esmolol (100 micrograms/kg per min) on the response of global cardiovascular and regional myocardial contractile function (sonomicrometry) to pacing-induced tachycardia and acute left ventricular afterloading was assessed in dogs with a critical stenosis of the left anterior descending coronary artery (LAD). These responses were observed at the baseline hemoglobin level (12.5 +/- 0.3 g/100 ml) as well as after hemodilution-induced mild regional contractile dysfunction (7.4 +/- 0.4 g/100 ml) in the area supplied by this artery (LAD area). Data were analyzed by using a repeated measures multivariate analysis of variance with complete block design treating pacing rate and afterloading, respectively, as the repeated measure.
Esmolol decreased the maximal first derivative of left ventricular pressure (dP/dtmax); global cardiovascular and regional myocardial contractile function were otherwise unchanged. Esmolol did not alter the response of global cardiovascular or regional myocardial function to pacing-induced tachycardia or to acute left ventricular afterloading, both at the baseline hemoglobin level as well as during mild hemodilution-induced LAD area contractile dysfunction.
At an infusion rate of 100 micrograms/kg per min we were unable to demonstrate cardioprotective esmolol effects in a canine model of critical coronary stenosis with controlled heart rate and identical loading conditions.
本研究旨在确定超短效β-肾上腺素能拮抗剂艾司洛尔是否具有与心率同时降低无关的心脏保护特性。
先前的研究已证明心率不变的β-肾上腺素能阻滞剂具有有益作用。
在左前降支冠状动脉（LAD）严重狭窄的犬中，评估艾司洛尔（100微克/千克每分钟）对整体心血管和局部心肌收缩功能（超声微测法）对起搏诱导的心动过速和急性左心室后负荷反应的影响。在基线血红蛋白水平（12.5±0.3克/100毫升）以及该动脉供血区域（LAD区域）经血液稀释诱导的轻度局部收缩功能障碍（7.4±0.4克/100毫升）后观察这些反应。分别将起搏频率和后负荷作为重复测量因素，采用完全区组设计的重复测量多变量方差分析对数据进行分析。
艾司洛尔降低了左心室压力的最大一阶导数（dP/dtmax）；整体心血管和局部心肌收缩功能在其他方面未发生变化。在基线血红蛋白水平以及轻度血液稀释诱导的LAD区域收缩功能障碍期间，艾司洛尔均未改变整体心血管或局部心肌功能对起搏诱导的心动过速或急性左心室后负荷的反应。
在以100微克/千克每分钟的输注速率给药时，我们无法在心率受控且负荷条件相同的严重冠状动脉狭窄犬模型中证明艾司洛尔具有心脏保护作用。
