普罗帕酮和普鲁卡因胺抗犬缺血性快速室性心律失常的对比研究(英文)

Comparative study of propafenone and procainamide on canine ischemic ventricular tachyarrhythmias

目的 观察普罗帕酮对犬在体心脏缺血性快速室性心律失常的心电生理影响并与普鲁卡因胺对比 ,以探讨其抗缺血性快速室性心律失常的效果及作用机制。方法 用冠状动脉左前降支结扎并部分再灌注法造成犬急性前壁心肌梗死 ,5～ 8d后 ,辅以心室程控电刺激 (PES)技术及冠状动脉内恒定微量直流电刺激技术 ,并诱发与终止持续性室性心动过速和心室纤颤 ,制备成犬急性心肌缺血再灌注后可控性快速室性心律失常的在体心脏心电模型 ,心电图对比观察普罗帕酮及普鲁卡因胺的抗心律失常作用。结果 普罗帕酮及普鲁卡因胺均能显著地延长心肌梗死犬的心电图QTc间期 (P <0 .0 1 )及正常和缺血心肌的有效不应期 (P <0 .0 1 ) ,降低缺血心肌和左室心肌的有效不应期离散度 (P <0 .0 1 ) ,提高正常心肌和缺血心肌的舒张期兴奋阈值 (P <0 .0 1 ) ,抑制PES诱发的持续性室性心动过速和心室纤颤 (P <0 .0 1 ) ,并能预防犬急性心肌梗死后再次缺血所致的自发性室性心动过速和心室纤颤 (P <0 .0 5)。结论 ①该犬在体心脏心电药理学实验模型具有较好的重复性、可靠性及临床相关性 ,是一种有价值的心电药理学实验研究模型。②普罗帕酮及普鲁卡因胺均具有抗缺血性快速室性心律失常的心电生理作用 ,是有效的抗颤药物 。

AIM To observe the electrophysiologic effects of propafenon e (Prop) on canine ischemic ventricular tachyarrhythmias and compared with those o f procainamide (PA), so as to evaluate the effect and mechanism of Prop on ische mic ventricular tachyarrhythmias. METHODS A canine ischemic ven tricular tachyarrhythmia model was established by the left anterior descending coronary artery occlusion for 2 h and reperfusion. Five to eight days later, op en-chest dogs were given programmed electrical stimulation (PES), and electroph ysiologic data were measured by electrocardiogram (ECG). RESULTS Bo th Prop and PA distinctly lengthened the QTc interval (P&lt;0.01) a nd effective refractory period (ERP) of normal and ischemic ventricular myocardi um respectively (P&lt;0.01) , decreased the dispersion of ERP in ischemic myocardium and in left ventricle (P&lt;0.01), and in creased the diastolic excitability threshold of normal and ischemic ventricular myocard ium remarkably (P&lt; 0.01) . Prop and PA effectively prevented P ES- or ischemia-induced ventricular tachycardia or ventricular fibrillation (P&lt;0.05, or P&lt;0.01). CONCLUSION The canine model is a worthy and reliable one. Prop and PA may be effective in preventi ng the on set of ventricular tachycardia or ventricular fibrillation after myocardial is chemic damage. The antiarrhythmic effects of both drugs are similar.