卡维地洛对大鼠心肌梗塞后左室功能及胶原改建的影响

目的 :在实验性大鼠心肌梗死模型上观察卡维地洛对心梗后左室功能及胶原改建的影响 .方法 :心梗后腹腔注射卡维地洛注射液 4wk或 8wk,用放免法测定血浆、心肌血管紧张素Ⅱ(AngⅡ)及血浆醛固酮 (ALD) ,动脉插管测定大鼠心功能 ,氯胺T法测定非梗塞区左室心肌羟脯氨酸含量 ,免疫组织化学法测定Ⅰ型胶原和Ⅲ型胶原含量的变化 .结果 :与心肌梗死对照组相比 ,卡维地洛可降低 8wk时的血浆、非梗死区心肌AngⅡ及血浆ALD水平 (P <0 0 5 ) ;治疗 4wk和 8wk后可明显升高 +dp/dtmax及 dp/dtmax水平 (P <0 0 5 ) ,减少非梗死区左室心肌羟脯氨酸的含量 ;降低非梗死区心肌Ⅰ型胶原和Ⅲ型胶原蛋白比值 (P <0 .0 5 ) .结论 :卡维地洛对心梗后左室功能及胶原改建可产生有益的影响 .ACEI类药物对逆转左室重塑也有有益的作用 ,二者在治疗上有协同作用     

卡维地洛联合地高辛治疗心力衰竭并心房颤动的效果

①目的评估联合应用卡维地洛与地高辛治疗心力衰竭并心房颤动的疗效和安全性.②方法 48例心力衰竭并心房颤动病人随机分为两组,应用地高辛0.25 mg/d治疗1周后,一组维持原治疗,另一组联用卡维地洛(5～20 mg/d)治疗3个月.治疗前后分别行超声心动图和动态心电图检查,评价左室功能和心室率.③结果 治疗前后卡维地洛联用地高辛组的静息心室率分别为(98.7±7.0)min-1和(76.3±6.0)min,治疗前后比较差异有显著性(t＝1 5.68,P＜0.01),其心室率变化较对照组明显(t＝5.49,P＜0.01).联合治疗组的左室射血分数(LVEF)、左室短轴缩短率(LVFS)、心排血量(CO)和E/A比值(E/A)有明显改善,两组比较差异有显著性(t＝3.46～37.67,P＜0.01).两组病人治疗前后均未发现明显副作用.④结论卡维地洛与地高辛合用治疗心力衰竭并心房颤动安全有效.     

卡维地洛和美托洛尔对慢性心衰患者心功能和心室重塑的影响

目的：观察卡维地洛和美托洛尔对慢性充血性心力衰竭（CHF）患者心功能和心室重塑的影响。方法：37例CHF患者，在常规治疗（洋地黄、利尿剂、血管紧张素转换酶抑制剂和硝酸盐类）的基础上，随机分为卡维地洛（A）组、美托洛尔（B组），治疗6个月。治疗前后分别进行心功能（NYHA）分级评估和症状评分，应用超声心动图测量左室短轴缩短分数（FS）、射血分数（EF）、左室舒张末期容积（LVEDV）和左室收缩末期容积（LVESV）。结果：治疗6个月后，两组的症状和心功能均有明显改善（P＜0．05）。A组较B组EF改善更明显（A组从35．8％到46．7％，P＜0．01；B组从37．4％到45．3％，P＜0．05），LVESV、LVEDV较治疗前均下降（P＜0．05），两组间无显著性差异，结论：卡维地洛与美托洛尔均能显著改善CHF的心功能，抑制心室重塑，前者在改善心室射血方面更优。     

常量卡维地洛对急性心肌梗死近期左心室功能的影响

目的　用超声心动图评价常量卡维地洛对急性心肌梗死后近期左心室功能的影响。方法　 74例急性心肌梗死患者 ,在用药前、用药 6个月后进行超声心动图检查。用修改的Simpson法经心尖四腔和二腔切面测定左心室收缩末容量、舒张末期容量和左室射血分数。结果　卡维地洛组心率比安慰剂组减慢 ,而安慰剂组左心室舒张末期容量和收缩末期容量增加 ,卡维地洛组容量减少。卡维地洛组左心室舒张末期容量指数比安慰剂组显著减少 (t =2 .470 ,P <0 .0 5 ) ;左心室收缩末期容量指数明显减少 (t =2 .6 86 ,P <0 .0 1) ,左心室射血分数增加 (t =2 .5 45 ,P<0 .0 5 )。结论　常量卡维地洛治疗急性心肌梗死 6个月 ,减少左心室容量 ,增加LVEF。     

A critical review of anti-adrenergic therapy in patients with heart failure and diabetes mellitus

Anti-adrenergic therapy has been widely accepted as an important therapeutic intervention in patients with chronic heart failure. However, there has been continuing controversy regarding the risks and clinical significance of metabolic effects of different anti-adrenergic drugs. This review summarizes what has been learned from clinical trial evidence regarding the benefits of anti-adrenergic drugs in diabetic patients with chronic heart failure.     

Antiarrhythmic activity in occlusion‐reperfusion model of 1‐(1H‐indol‐4‐yloxy)‐3‐{[2‐(2‐methoxyphenoxy)ethyl]amino} propan‐2‐ol and its enantiomers

Acute myocardial infarction (AMI) is a leading cause of mortality and morbidity worldwide, especially in developed countries. The most serious problem after myocardial infarction is reperfusion injury that manifests as functional impairment, arrhythmia, and accelerated progression of cell death in certain critically injured myocytes. Subsequently the infarcted myocardium develops features of necrosis and reactive inflammation. To reduce lethal reperfusion injury in patient with AMI antioxidants, anti‐inflammatory agents, adenosine, opioids, metabolic modulators (glucose, insulin, and potassium, nicorandil and agents which reduce intracellular Ca²⁺ overload and inhibit Na⁺‐H⁺ exchange) are used. In this study a novel compound (compound 9) 1‐(1 h‐indol‐4‐yloxy)‐3‐{[2‐(2‐methoxyphenoxy) ethyl]amino}propan‐2‐ol and its enantiomers are examined in arrhythmia associated with coronary artery occlusion and reperfusion in a rat model. Antioxidant properties are also determined for test compounds using the malondialdehyde (MDA) lipid peroxidation and ferric reducing antioxidant power (FRAP) tests. In summary, the tested compounds, especially the S enantiomer has a strong antiarrhythmic activity in a model of occlusion and reperfusion of the left coronary artery which is probably related to their adrenolytic action. In contrast to carvedilol, none of the test compound reduced the lipid peroxidation but increased ferric reducing antioxidant power. In the antioxidant effect, there was no difference between the optical forms of compound 9.     

卡维地洛联合缬沙坦对慢性心力衰竭患者心功能及神经内分泌功能的影响

目的观察卡维地洛联合缬沙坦对慢性心力衰竭患者心功能及神经内分泌功能的影响。方法选取2017年6月至2018年9月我院收治的84例慢性心力衰竭患者为研究对象,根据随机分组将其分为对照组与观察组,各42例。对照组给予缬沙坦治疗,观察组在对照组基础上给予卡维地洛治疗,比较两组的治疗效果。结果治疗后,两组的LVEF均升高,LVESD、LVEDD均降低,且观察组优于对照组(P <0. 05)。治疗后,两组的AngⅡ、PRA、ALD水平均降低,且观察组低于对照组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论缬沙坦联合卡维地洛治疗慢性心力衰竭可改善患者心功能及神经内分泌功能,且不良反应较少。     

卡维地洛治疗心力衰竭的疗效观察

目的 观察卡维地洛对充血性心力衰竭(CHF)的临床疗效。方法 将52例CHF患者随机分为卡维地洛组和常规治疗组，卡维地洛组在常规抗心衰治疗的基础上给予卡维地洛；常规治疗组采用安慰剂加常规抗心衰治疗。结果 卡维地洛治疗5个月后心功能及超声指标与常规治疗组相比均明显改善。结论 卡维地洛对充血性心力衰竭的治疗有显著效果。     

卡维地洛与美托洛尔治疗缺血性心脏病心力衰竭的疗效观察

目的:观察卡维地洛和美托洛尔对缺血性心脏病心力衰竭患者的临床疗效。方法:缺血性心脏病心力衰竭患者80例,左室射血分数（LVEF）≤0.45,心功能（NYHA）ⅡⅣ级,常规治疗基础上随机分为卡维地洛组和美托洛尔组,治疗3月后,观察两种药物对心功能及运动耐量的影响。应用心脏彩色超声仪测定心功能基线值及3月后的变化。用6 m in步行距离测定运动耐量的改善程度。结果:经过3月的治疗,卡维地洛组与美托洛尔组心率、血压、运动耐量改善程度及心功能均有明显改善,且卡维地洛组6 m in步行试验结果,收缩压、舒张压变化及左室收缩末容积（LVESV）、左室舒张末容积（LVEDV）、LVEF改善程度明显优于美托洛尔组（P<0.01）。结论:在常规治疗基础上卡维地洛、美托洛尔对缺血性心脏病的治疗均有显著效果,前者在改善运动耐量、LVEDV、LVESV及心室射血方面更优。