钾通道开放剂尼可地尔对心动过缓依赖性室性早搏的临床抑制作用。
Clinical suppression of bradycardia dependent premature ventricular contractions by the potassium channel opener nicorandil.
作者信息
Takahashi N, Ito M, Saikawa T, Arita M, Fujino T, Kagiyama H, Fukumoto T, Sakata T
机构信息
Department of Internal Medicine I, School of Medicine, Oita Medical University, Japan.
出版信息
Heart. 1998 Jan;79(1):64-8. doi: 10.1136/hrt.79.1.64.
OBJECTIVE
To assess the clinical antiarrhythmic effect of nicorandil, a potassium channel opener; on premature ventricular contractions.
DESIGN AND PATIENTS
The effect of oral nicorandil (15 to 60 mg daily for four weeks) on premature ventricular contractions was investigated in 20 patients (11 female, nine male, mean (SD) age 63 (17) years) who underwent 24 hour ambulatory ECG. Patients were classified into two groups based on the relation between the frequency of premature ventricular contractions and heart rate: (1) those with a positive correlation (n = 9); and (2) those with a bidirectional correlation (n = 11), characterised by an increased frequency of premature contractions at low heart rates and a decreased frequency at high heart rates.
RESULTS
Nicorandil reduced the frequency of premature ventricular contractions by 75% in five patients in group 2, but was not effective in any patient in group 1. The heart rate at which the frequency of premature ventricular contractions peaked was significantly lower in the five responders in group 2 than in the six non-responders (63.2 (3.7) v 76.3 (12.4) beats/min, p < 0.05).
CONCLUSIONS
Nicorandil may suppress premature ventricular contractions when they occur mainly at a low heart rate.
目的
评估钾通道开放剂尼可地尔对室性早搏的临床抗心律失常作用。
设计与患者
对20例（11例女性，9例男性，平均（标准差）年龄63（17）岁）接受24小时动态心电图监测的患者，研究口服尼可地尔（每日15至60毫克，共四周）对室性早搏的影响。根据室性早搏频率与心率的关系将患者分为两组：（1）呈正相关的患者（n = 9）；（2）呈双向相关的患者（n = 11），其特征为低心率时早搏频率增加，高心率时早搏频率降低。
结果
尼可地尔使第2组中的5例患者室性早搏频率降低了75%，但对第1组中的任何患者均无效。第2组中5例有反应者室性早搏频率达到峰值时的心率显著低于6例无反应者（63.2（3.7）对76.3（12.4）次/分钟，p < 0.05）。
结论
当室性早搏主要在低心率时发生时，尼可地尔可能会抑制室性早搏。
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