Singh S
VA Medical Center of Cardiology, Washington, DC 20422, USA.
Int J Clin Pract. 1998 Sep;52(6):432-5.
Originally developed as an antianginal agent, amiodarone was soon found to have antiarrhythmic properties and to be a non-competitive inhibitor of alpha and beta-adrenergic receptors. Many trials studying the use of amiodarone in patients with heart failure have now been performed and are reviewed in this article. The trials appear to show that amiodarone possesses significant antiarrhythmic activity, even in heart failure patients. The drug appears to be well tolerated and proarrhythmia is uncommon. Based on the findings of a large Argentinian randomised trial (GESICA) and the Congestive Heart Failure Survival Trial of Antiarrhythmic Therapy (CHF STAT), it would appear there is a role for amiodarone in patients with non-ischaemic cardiomyopathy, but prospective studies are required to confirm this. The benefit of amiodarone in patients with non-ischaemic cardiomyopathy might be related to the beta-blocking effect that is seen with the use of conventional beta-blockers. Further studies, including the Sudden Cardiac Death Heart Trial (SCD HeFT), should help determine the role of amiodarone in heart failure patients.
胺碘酮最初作为一种抗心绞痛药物研发，很快就被发现具有抗心律失常特性，并且是α和β肾上腺素能受体的非竞争性抑制剂。现在已经进行了许多研究胺碘酮在心力衰竭患者中应用的试验，本文对这些试验进行综述。这些试验似乎表明，即使在心力衰竭患者中，胺碘酮也具有显著的抗心律失常活性。该药物耐受性良好，致心律失常情况并不常见。基于阿根廷一项大型随机试验（GESICA）和抗心律失常治疗充血性心力衰竭生存试验（CHF STAT）的结果，胺碘酮在非缺血性心肌病患者中似乎有一定作用，但需要前瞻性研究来证实这一点。胺碘酮在非缺血性心肌病患者中的益处可能与使用传统β受体阻滞剂时所见的β受体阻滞作用有关。包括心脏性猝死心脏试验（SCD HeFT）在内的进一步研究应有助于确定胺碘酮在心力衰竭患者中的作用。
