Kieback A G, Iven H, Stolzenburg K, Baumann G
Charité, I. Medical Department, Humboldt-University, Berlin, Germany.
J Cardiovasc Pharmacol. 1998 Oct;32(4):629-36. doi: 10.1097/00005344-199810000-00016.
The acute hemodynamic effects of the phosphodiesterase (PDE) III inhibitor saterinone were compared with dobutamine and sodium nitroprusside in 12 patients with idiopathic congestive cardiomyopathy (NYHA III). Hemodynamic measurements were obtained with a Swan-Ganz thermodilution catheter. At the peak of its dose-response curve, saterinone induced an increase in cardiac index (+102%), stroke volume (+97%), and heart rate (+6%), paralleled by a decrease in pulmonary capillary wedge pressure (-46%), right atrial pressure (-51%), pulmonary arterial pressure (systolic -32%, diastolic -45%, mean -38%), systemic blood pressure (systolic -3%, diastolic -13%, mean -9%), systemic vascular resistance (-54%), and pulmonary vascular resistance (-58%). Dobutamine had similar effects on cardiac index (+106%) and stroke volume (+87%) but lacked vasodilatory characteristics. In contrast to dobutamine, both nitroprusside and saterinone demonstrated more pronounced vasodilatory effects. Nitroprusside was less effective on cardiac index (+66%) and stroke volume (+56%) than was saterinone. The double product was markedly increased by dobutamine (+28%), did not change with saterinone treatment (+2%), and decreased with nitroprusside (-10%). This indicates that according to double product, only the application of dobutamine caused a relevant increase in myocardial oxygen consumption. Saterinone was demonstrated to be a safe and potent drug on short-term application; it combines the vasodilating properties of sodium nitroprusside with the positive inotropic effects of dobutamine without major changes in myocardial oxygen consumption.
在12例特发性充血性心肌病（纽约心脏协会Ⅲ级）患者中，比较了磷酸二酯酶（PDE）Ⅲ抑制剂沙替利酮与多巴酚丁胺和硝普钠的急性血流动力学效应。使用Swan-Ganz热稀释导管进行血流动力学测量。在剂量-反应曲线的峰值时，沙替利酮使心脏指数增加（+102%）、每搏量增加（+97%）、心率增加（+6%），同时肺毛细血管楔压降低（-46%）、右心房压降低（-51%）、肺动脉压降低（收缩压-32%，舒张压-45%，平均压-38%）、体循环血压降低（收缩压-3%，舒张压-13%，平均压-9%）、体循环血管阻力降低（-54%）和肺血管阻力降低（-58%）。多巴酚丁胺对心脏指数（+106%）和每搏量（+87%）有类似作用，但缺乏血管舒张特性。与多巴酚丁胺不同，硝普钠和沙替利酮均表现出更明显的血管舒张作用。硝普钠对心脏指数（+66%）和每搏量（+56%）的作用不如沙替利酮有效。多巴酚丁胺使双倍乘积显著增加（+28%），沙替利酮治疗时未改变（+2%），硝普钠治疗时降低（-10%）。这表明根据双倍乘积，仅应用多巴酚丁胺会导致心肌耗氧量有相关增加。沙替利酮在短期应用时被证明是一种安全有效的药物；它兼具硝普钠的血管舒张特性和多巴酚丁胺的正性肌力作用，而心肌耗氧量无重大变化。
