Tanabe K, Suzuki N, Osada N, Yamamoto A, Nakayama M, Yokoyama Y, Sakakibara M, Itoh H, Murayama M, Yamada S, Yamasaki H
Second Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Jpn Circ J. 1996 Nov;60(11):831-40. doi: 10.1253/jcj.60.831.
The present study was conducted to investigate the effects of cilazapril on exercise tolerance and the hormone kinetics of catecholamines, the reninangiotensin-aldosterone system and alpha-atrial natriuretic peptide (ANP) in patients in the chronic phase of acute myocardial infarction (AMI). The subjects consisted of 19 cases of AMI. Cardiopulmonary exercise testing was performed 1 month after the onset of AMI, and patients were randomly assigned to either a group treated with 1 mg/day of cilazapril (9 cases) and or an untreated group (10 cases). After the completion of 2 months of exercise training at the anaerobic threshold (AT), blood samples were taken during a cardiopulmonary exercise test and various hormones were measured. In comparing the parameters of exercise tolerance before and after the completion of exercise training there were no significant differences between the 2 groups with respect to oxygen uptake, oxygen pulse, or exercise time at AT or at peak exercise. With regard to temporal changes in exercise tolerance, oxygen uptake, oxygen pulse and exercise time all tended to increase in both groups. With regard to hormone kinetics, the alpha-ANP concentration at peak exercise was significantly lower, and the noradrenaline secretions also tended to be lower, in the cilazapril-treated group, even though the peak exercise time was similar in both groups. These results may be support the hypothesis that cilazapril mitigates the left ventricular load during exercise therapy in patients in the chronic phase of AMI.
本研究旨在探讨西拉普利对急性心肌梗死（AMI）慢性期患者运动耐量以及儿茶酚胺、肾素 - 血管紧张素 - 醛固酮系统和α - 心房利钠肽（ANP）激素动力学的影响。研究对象为19例AMI患者。在AMI发病1个月后进行心肺运动试验，患者被随机分为两组，一组接受每日1毫克西拉普利治疗（9例），另一组为未治疗组（10例）。在无氧阈（AT）水平完成2个月的运动训练后，在心肺运动试验期间采集血样并测量各种激素。在比较运动训练完成前后的运动耐量参数时，两组在摄氧量、氧脉搏或AT及运动峰值时的运动时间方面无显著差异。关于运动耐量的时间变化，两组的摄氧量、氧脉搏和运动时间均有增加趋势。关于激素动力学，尽管两组的运动峰值时间相似，但在西拉普利治疗组中，运动峰值时的α - ANP浓度显著降低，去甲肾上腺素分泌也有降低趋势。这些结果可能支持以下假设：西拉普利可减轻AMI慢性期患者运动治疗期间的左心室负荷。
