Effects of intrinsic sympathetic activity of beta-blockers on SA and AV nodes in man.

European journal of cardiology Pub Date : 1981-01-01
J F Leclercq, M D Rosengarten, S Kural, P Attuel, P Coumel
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Abstract

The authors compare the effects of beta-blockers without intrinsic sympathetic activity (ISA) (propranolol, 160 mg/day), moderate ISA (acebutolol, 800 mg/day) and high ISA (pindolol, 20 mg/day). The sinus rate decreases more with propranolol than with acebutolol, during the day (P less than 0.01) and during the night (P less than 0.001), whereas pindolol does not change the daylight rate and increases the nighttime rate (P less than 0.001). The ventricular rate during atrial fibrillation (AV nodal transmission) is modified as is sinus rate. There is no significant difference between propranolol and acebutolol, and a highly significant difference between pindolol and propranolol (P less than 0.001) or acebutolol (P less than 0.01). Moreover, the eurythmic effect of beta-blockers, making RR intervals more regular, is maximal with propranolol and minimal with pindolol, as judged on RR interval histograms. The ISA of the beta-blockers is of major importance for the clinical use of these drugs, and in the case of SA or AV node dysfunction ISA can be useful, but it can obscure the beneficial effects of beta-blocking therapy.

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受体阻滞剂内在交感神经活性对人SA和AV淋巴结的影响。
作者比较了无内源性交感神经活动(ISA)的β受体阻滞剂(心得安,160毫克/天)、中等ISA(乙酰丁胺醇,800毫克/天)和高ISA(品多洛尔,20毫克/天)的效果。在白天(P < 0.01)和夜间(P < 0.001),心得安组窦率下降幅度大于乙酰丁胺醇组,而品多洛尔组窦率升高(P < 0.001),但对白天窦率无明显影响。房颤(房室结传递)期间的心室率和窦率一样被改变。心得安与乙酰布洛尔无显著差异,品多洛尔与心得安(P < 0.001)、乙酰布洛尔(P < 0.01)差异极显著。此外,从RR间期直方图判断,受体阻滞剂的心律调节作用,使RR间期更有规律,在心得安组最大,在品多洛尔组最小。受体阻滞剂的ISA对这些药物的临床应用具有重要意义,在SA或房室结功能障碍的情况下,ISA可能是有用的,但它可能会掩盖β阻断治疗的有益效果。
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