Slany J, Mösslacher H
Klin Wochenschr. 1976 Jul 15;54(14):671-6. doi: 10.1007/BF01469147.
In order to examine the question, whether improved digitalis tolerance by Spirolactone may be partially a result of antagonism on myocardial potassium balance, 6 patients without clinical signs of heart failure were given 400 mg, 3 were given 200 or 300 mg Spirolactone orally daily and 6 patients received placebo during a 5 to 7 days period. During cardiac catheterization hemodynamics and serum potassium concentrations were determined repeatedly prior to and following intravenous administration of 0,375 to 0,625 mg Strophanthin. Injection of Strophanthin resulted in a significant drop in left ventricular enddiastolic pressure and a rise in dp/dt max. In the control group a significant increase in arterial and coronary sinus potassium concentration was observed. Myocardial potassium balance was definitely negative from the third to the eighth minute. Values in the group receiving Spirolactone did not differ significantly from the placebo group. It is suggested that therapeutic doses of Strophanthin resllt in a loss of potassium from the myocardium by inhibition of the Na+, K+ membrane ATPase not influenced by pretreatment with Spirolactone.
为了研究安体舒通改善洋地黄耐受性是否可能部分是心肌钾平衡拮抗作用的结果，对6例无心力衰竭临床体征的患者每日口服400毫克安体舒通，3例每日口服200或300毫克安体舒通，6例患者在5至7天期间服用安慰剂。在心脏导管插入术期间，在静脉注射0.375至0.625毫克毒毛旋花子苷之前和之后反复测定血流动力学和血清钾浓度。注射毒毛旋花子苷导致左心室舒张末期压力显著下降和dp/dt max升高。在对照组中，观察到动脉和冠状窦钾浓度显著增加。从第三分钟到第八分钟，心肌钾平衡肯定为负。接受安体舒通治疗的组的值与安慰剂组没有显著差异。提示治疗剂量的毒毛旋花子苷通过抑制Na +、K +膜ATP酶导致心肌钾流失，而不受安体舒通预处理的影响。
