Günal A I, Işik A, Celiker H, Eren O, Celebi H, Günal S Y, Lüleci C
Department of Internal Medicine, First University Faculty of Medicine, Elaziö, Turkey.
Heart. 1996 Nov;76(5):418-21. doi: 10.1136/hrt.76.5.418.
Growth factors have been shown to be associated with primary hypertrophic cardiomyopathy. Octreotide, a long acting somatostatin analogue, can prevent the stimulating effect of growth factors and decrease the left ventricular mass in patients with acromegaly. In the light of these results, three patients with primary hypertrophic cardiomyopathy were treated with subcutaneous octreotide (50 micrograms three times a day during the first week and 100 micrograms twice a day for the following three weeks). Initially, two patients were in New York Heart Association class II in and one was in class III. At the end of a four week treatment session all were in class I. There were significant decreases in left ventricular posterior wall thickness, interventricular septum thickness, and left ventricular mass in all three patients. Both left ventricular end diastolic and end systolic diameters had increased in all of the patients at the end of the fourth week. Two of three patients showed improved diastolic filling: their hyperdynamic systolic performance returned to normal. No side effects were observed during octreotide treatment. The considerable improvement obtained with the short term octreotide treatment in patients with primary hypertrophic cardiomyopathy seems promising.
生长因子已被证明与原发性肥厚型心肌病有关。奥曲肽是一种长效生长抑素类似物,可阻止生长因子的刺激作用,并降低肢端肥大症患者的左心室质量。鉴于这些结果,对3例原发性肥厚型心肌病患者采用皮下注射奥曲肽治疗(第一周每天3次,每次50微克,随后三周每天2次,每次100微克)。最初,2例患者为纽约心脏协会II级,1例为III级。在为期4周的治疗结束时,所有患者均为I级。所有3例患者的左心室后壁厚度、室间隔厚度和左心室质量均显著降低。在第四周结束时,所有患者的左心室舒张末期和收缩末期直径均增加。3例患者中有2例舒张期充盈得到改善:其高动力性收缩功能恢复正常。在奥曲肽治疗期间未观察到副作用。短期奥曲肽治疗原发性肥厚型心肌病患者取得的显著改善似乎很有前景。