閉塞性心不全における非選択的対選択的β-アドレネルゲン受容体阻害:交感性活動に対する差異的な効果
1Division of Cardiology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Ontario, Winnipeg, Canada.
Circulation
|October 31, 2001
まとめ
カーベディロールは非選択的β-ブロッカーであり,メトプロロールとは異なり,心不全患者のノレピネフリン放出を減少させます. このシンパト抑制効果は,周辺ベータアドレナリン受容体を阻害することによって媒介されます.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- 神経科学は神経科学である.
背景:
- 交感神経系の活性化が慢性心不全の予後に影響する.
- ベータアドレネルゲン受容体アンタゴニストは,ノルエピネフリン放出を差異的に影響する可能性があります.
- 前接点のβ2 adrenergic受容体は,神経末端からノレピネフリンの放出を媒介する.
研究 の 目的:
- 慢性心不全における共感神経系の活動に対する非選択カルベディロールと選択メトプロロールの効果を比較する.
- 交差前ベータ (((2) - アドレナージック受容体が,交感抑制効果を媒介する役割を調査する.
主な方法:
- 36人の慢性心不全患者のランダム化,ダブルブラインド研究.
- カルベディロールとメトプロロールの4ヶ月の比較.
- 測定には,血液動力学,ノレピネフリン溢出,および筋肉交感神経のトラフィックが含まれていました.
主要な成果:
- カーベディロールは,全身および心臓のノレピネフリン溢出を著しく減少させた.
- メトプロロールはノレピネフリン溢出を有意に変化させなかった.
- どちらの薬も,筋肉の交感神経の伝達に影響を及ぼさなかったが,どちらも心拍数を低下させた.
結論:
- カーベディロールは非選択的β阻害剤であり,心不全でノレピネフリンの放出を減少させます.
- このシンパトオインヒビトー効果は,選択的メトプロロールでは見られない.
- カーベディロルの効果は,周辺の,前接点のβ-アドレナリン受容体を阻害するからである可能性が高い.
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