氨氯地平对冠心病心衰患者心脏舒缩功能的效应

Effects of amlodipine on cardiac function of patients with coronary artery disease complicated by heart failure

为观察氨氯地平对冠心病心衰患者心脏功能的效应，作者采用核素心血池显像术，测定２８例冠心病心衰患者口服氨氯地平１０ｍｇ后，左、右心功能参数及平均动脉压与心率的变化，以１２例心功能Ⅰ级冠心病患者口服安慰剂作对照。结果显示：心衰患者服药前后平均动脉压、射血分数、最大射血率、最大射血率出现时间、右室射血分数有明显差异；而最大充盈率、最大充盈率出现时间与心率无明显变化；心功能Ⅲ级与Ⅳ级患者上述指标差异显著，而心功能Ⅱ级患者各项指标均无明显差异。提示，氨氯地平在降低冠心病心衰患者平均动脉压而不影响心率的情况下，可显著改善心衰患者的左、右室收缩功能，而对左室舒张功能无明显影响，其改善心功能的效应似与心衰的严重程度有关。

For the purpose of investigating effects of amlodipine on cardiac function of patients with coronary artery disease complicated by heart fuilure,cardiac functional indices of left and right ventricles as well as mean artery pressure(MAP) and heart rate(HR) were measured by nuclide cardiovascular radiography in 28 patients with coronary artery disease complicated by heart failure(NYHA classes Ⅱ￣Ⅳ) who had taken 10 mg amlodipine as experimental group and 12 class Ⅰ patients with coronary artery disease who had taken placebo as control group. The results showed that MAP, the left ventricular ejection fraction(LVEF),the peak ejection rate(PER), the time of its occurrence(TEO),and the right ventricular ejection fraction(RVEF) were of siginificant difference,whereas the peak filling rate(PFR) and the time of its occurrence(TFO),as well as HR were of no significant difference before and after taking the drug. All indices mentioned above were significantly different in class Ⅲ as well as in class Ⅳ patients and were not in class Ⅱ patients. The results suggest that the drug may effectively improve systolic performance in patients with coronary artery disease complicated by heart failure while it can lower MAP without affecting HR. The effect of amlodipine on cardiac function seems to be closely related to severity of heart failure.