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JAHA：多非利特与美西律在预防心房颤动上具有协同效应！

2017-05-20 xing.T MedSci原创

多非利特美西律房颤协同效应
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多非利特与美西律合用不仅协同地增加心房ERP，有效地抑制房颤诱发，而且还可显著减小单独使用多非利特导致QT和扭转型室性心动过速的风险。

虽然心房颤动（AF）是最常见的心脏节律异常，其发病率持续上升，并且缺乏安全有效的抗心律失常药物来治疗房颤，近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，该研究旨在检测联合使用多非利特与美西律是否在抑制房颤上具有协同作用，并且安全不会出现药物诱导的心室致心律失常。

研究人员使用孤立动脉灌注兔心房和心室楔形标本来研究多非利特合用美西律对心房有效不应期（ERP）、房颤诱发、QT和QT相关的室性心律失常的效应。

多非利特或美西律单独使用仅轻度至中度延长心房ERP，但是他们的合用可以使心房ERP产生一个显著的起博频率依赖性增加。在起搏频率为0.5 Hz时，多非利特（3nmol/L）加美西律（10μmol/L）使ERP增加28.2%，从72.2±5.7到92.8±5.9ms（n=9，P＜0.01），在起博频率为3.3Hz时，增加了94.5%，从91.7±5.2到178.3±12ms（n=9，P<0.01）。多非利特加美西律治疗可以显著抑制房颤诱发。另一方面，多非利特为10nmol/L时可以产生明显的QT和TP-E延长，更加陡峭的QT-BCL和TP-E-BCL斜率，并诱发早期后除极及尖端扭转型室楔。美西律为10μmol/L时可以降低多非利特诱导的QT和TP-E延长，QT-BCL和TP-E-BCL的斜率，并停止早期后除极和扭转型室性心动过速。

由此可见，多非利特与美西律合用不仅协同地增加心房ERP，有效地抑制房颤诱发，而且还可显著减小单独使用多非利特导致QT和扭转型室性心动过速的风险。

原始出处：

Guizhi Liu, et al. Synergistic Effect of Dofetilide and Mexiletine on Prevention of Atrial Fibrillation.JAHA.2017. https://doi.org/10.1161/JAHA.117.005482

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    2017-05-22 zhaohui6731

    #AHA#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1267449, encodeId=eb38126e4495a, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626841, encodeId=574216268410e, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200606, encodeId=5d6c20060645, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun May 21 00:29:55 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200520, encodeId=63472005206e, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat May 20 19:15:06 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-22 sodoo

    #心房#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1267449, encodeId=eb38126e4495a, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626841, encodeId=574216268410e, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200606, encodeId=5d6c20060645, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun May 21 00:29:55 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200520, encodeId=63472005206e, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat May 20 19:15:06 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-21 tanxingdoctor

    学习啦谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1267449, encodeId=eb38126e4495a, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1626841, encodeId=574216268410e, content=<a href='/topic/show?id=986a5101e46' target=_blank style='color:#2F92EE;'>#心房#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51017, encryptionId=986a5101e46, topicName=心房)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20ba21064884, createdName=sodoo, createdTime=Mon May 22 08:14:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200606, encodeId=5d6c20060645, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun May 21 00:29:55 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200520, encodeId=63472005206e, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sat May 20 19:15:06 CST 2017, time=2017-05-20, status=1, ipAttribution=)]
    2017-05-20 天涯183

    非常好的文章，学习了，很受益

    0