胺碘酮和索他洛尔对心肌复极不均一性的影响  

Effect of sotalol and amiodarone on repolarization heterogeneity of myocardium across the left ventricular wall in vivo

作　　者：李运田[1] 张存泰[1] 陆再英 

机构地区：[1]同济医科大学附属同济医院心内科,武汉430030

出　　处：《中华心律失常学杂志》2000年第4期284-288,共5页Chinese Journal of Cardiac Arrhythmias

基　　金：卫生部科研基金课题(98-02-095)

摘　　要：目的　比较胺碘酮和索他洛尔对心肌复极不均一性的影响 ,探讨它们致尖端扭转性室性心动过速 (torsade de pointes,Td P)发生率不同的原因。　方法　采用单相动作电位 (MAP)记录技术 ,同步记录 2 4只开胸兔左心室心外膜心肌 (epicardium ,Epi)、中层心肌 (midmyocardium ,Mid)和心内膜心肌 (endocardium ,Endo)的 MAP,分别静脉注射胺碘酮和索他洛尔后 ,比较两种药物对心肌复极不均一性的影响。　结果　 1两种药物均降低心率 ,延长 QT间期 ;2大剂量索他洛尔明显增加 3层心肌的复极离散度 ,诱发早期后除极 (early afterde- polarization,EAD)和 Td P;3胺碘酮使 3层心肌的复极趋于一致 ,无 EAD和 Td P发生。　结论　胺碘酮和索他洛尔对心肌复极不均一性产生不同的影响是两种药物致 TdObjective To compare the effect of amoidarone and sotalol on repolarization heterogeneity of myocardium across the left ventricular wall and investigate the cause of their different incidences of proarrhythmias. Methods With the monophasic action potential (MAP) recording technique,MAPs of Epi、Mid(2 5mm from Epi) and Endo were recorded by specially designed plunge needle electrodes at the left ventricular myocardium in 24 open chest rabbits.After intravenous injection of amoidarone and sotalol separately,effects of both drugs on action potential duration at 100% repolarization (APD 100 ) and transmural dispersion of repolarization (TDR) among three myocardial layers as well as EAD were compared. Results 1.Both drugs reduced the heart rate and lengthened QT intervals.2.sotalol increased TDR among three myocardial layers with different doses,and induced the EAD as well as TdP.3.amoidarone made the repolarization durations consisent in three myocardial layers and did not induce the EAD and TdP. Conclusion sotalol and amoidarone have different effects on repolarization heterogeneity of myocardium across the left ventricular wall and the different incidences of TdP by these drugs are related to that mechanism.

关 键 词：单相动作电位 胺碘酮 索他洛尔 复极不均一性 

分 类 号：R542.2[医药卫生—心血管疾病]