Simarro E, Rodríguez M A, Bayón J, Lastra J A, Prieto P, Suárez G, García Porrero E, Fernández R, Garrido J, Velasco J
Servicio de Cardiología, Complejo Hospitalario Insalud, León.
Rev Esp Cardiol. 1995 Nov;48(11):741-5.
Calcium channel blockers have been wide and successfully used in the treatment of coronary heart disease. Gallopamil, a metoxylic derivative of verapamil, has many of its properties and so, caution is recommended when given to patients with depressed left ventricular function. Clinical studies about this effect are scarce, and we have assessed it in patients with coronary heart disease and diminished left ventricular function.
We studied 20 patients in a cross-over, randomized, double-blind study during three weeks active periods with two intercalating washout placebo periods of one week. Patients had history of previous myocardial infarction, positive exercise stress test and ejection fraction ranging from 30% to 50% by echocardiography.
There were no significant differences between each drug and corresponding placebo on either systolic or diastolic function. When we compared both drugs, patients showed a milder increase in area under E after propranolol than after gallopamil (p < 0.008). Clinical episodes of cardiac failure were not reported, and ejection fraction did not change.
Both gallopamil and propranolol can be used in patients with coronary heart disease and moderately depressed left ventricular ejection fraction.
钙通道阻滞剂已广泛且成功地应用于冠心病的治疗。加洛帕米是维拉帕米的甲氧基衍生物，具有许多维拉帕米的特性，因此，对于左心室功能减退的患者给药时需谨慎。关于这种影响的临床研究很少，我们在冠心病且左心室功能减退的患者中对此进行了评估。
我们在一项交叉、随机、双盲研究中对20例患者进行了研究，研究为期三周的活跃期，中间穿插两个为期一周的洗脱安慰剂期。患者有既往心肌梗死病史、运动负荷试验阳性，且超声心动图显示射血分数在30%至50%之间。
每种药物与相应安慰剂在收缩功能或舒张功能方面均无显著差异。当我们比较两种药物时，患者服用普萘洛尔后E波下面积的增加幅度小于服用加洛帕米后（p < 0.008）。未报告心力衰竭的临床发作，射血分数也未改变。
加洛帕米和普萘洛尔均可用于冠心病且左心室射血分数中度降低的患者。
