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血管紧张素转化酶抑制剂——巯甲丙脯酸(cap-topril)是强烈的降压药,现已证明,该药也有缓解血压正常患者的心力衰竭症状,改善左室功能作用,可用于慢性心力衰竭的长期治疗。但对冠状循环的作用报道甚少。本文着重研究此药对冠脉血流动力学与心肌代谢的作用。研究对象为15例46～70岁的男性患者,心电图均有前壁心肌梗塞表现,4例冠状动脉造影有严重3支血管病变。研究时均有双侧心室衰竭及肺动脉高压。二维超声心动图或血管造影显示左心室扩大,收缩性差。10例属Ⅲ级心衰,5例Ⅳ级心衰。用漂浮导管测量右房、肺动脉及肺毛细血管楔压,用热稀释法测心输出量,并用热稀释法冠状窦流量导管作
The angiotensin converting enzyme inhibitor cap-topril is a strong antihypertensive drug. It has also been shown that it also relieves symptoms of heart failure and improves left ventricular function in normotensive patients and can be used in Long-term treatment of chronic heart failure. However, the role of the coronary circulation rarely reported. This article focuses on the effect of this drug on coronary hemodynamics and myocardial metabolism. The subjects were 15 male patients aged 46 to 70 years. The electrocardiogram showed anterior myocardial infarction. The coronary angiography in 4 patients had severe 3-vessel disease. Study both bilateral ventricular failure and pulmonary hypertension. Two-dimensional echocardiography or angiography showed left ventricular enlargement, poor contractility. 10 cases were grade Ⅲ heart failure, 5 cases of grade Ⅳ heart failure. Floating catheter was used to measure the wedge pressure of right atrium, pulmonary artery and pulmonary capillary. The cardiac output was measured by thermal dilution method. The coronary sinus flow catheter