Kaku T, Himeno E, Nakashima Y, Kuroiwa A
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Artery. 1994;21(4):193-207.
Ca++-antagonist is effective not only for variant angina but also for effort angina. The effects of sustained release diltiazem (diltiazem-R) and beta 1-blocker (atenolol) on exercise tolerance were studied in seven patients with stable effort angina in a cross over trial. Diltiazem-R (100mg) or atenolol (50mg) was given once a day, each treatment period lasting for two weeks after a two-week control period. The treadmill exercise test was performed on the last day of each protocol. Both diltiazem-R and atenolol decreased heart rate at rest and the decrease with atenolol was greater than that with diltiazem-R. The systolic blood pressure was unchanged at rest by both drugs. At maximal work levels, atenolol decreased the heart rate and pressure rate product significantly but diltiazem-R did not. Both diltiazem-R and atenolol significantly prolonged the exercise time (average 137 and 165 seconds respectively), time to onset of 1mm ST depression (240 and 288 seconds respectively). There was no significant difference in exercise tolerance between diltiazem-R and atenolol. These findings suggest that diltiazem-R, a sustained release Ca++-antagonist, provides beneficial effects in patients with stable effort angina.
钙拮抗剂不仅对变异型心绞痛有效，对劳力型心绞痛也有效。在一项交叉试验中，研究了缓释地尔硫䓬（地尔硫䓬 -R）和β1受体阻滞剂（阿替洛尔）对7例稳定型劳力型心绞痛患者运动耐量的影响。地尔硫䓬 -R（100毫克）或阿替洛尔（50毫克）每日给药一次，在为期两周的对照期后，每个治疗期持续两周。在每个方案的最后一天进行平板运动试验。地尔硫䓬 -R和阿替洛尔均降低静息心率，且阿替洛尔的降低幅度大于地尔硫䓬 -R。两种药物对静息时的收缩压均无影响。在最大工作水平时，阿替洛尔显著降低心率和压力心率乘积，但地尔硫䓬 -R未降低。地尔硫䓬 -R和阿替洛尔均显著延长运动时间（分别平均延长137秒和165秒）、1毫米ST段压低出现的时间（分别为240秒和288秒）。地尔硫䓬 -R和阿替洛尔之间的运动耐量无显著差异。这些发现表明，缓释钙拮抗剂地尔硫䓬 -R对稳定型劳力型心绞痛患者具有有益作用。
