Abstract:
:We determined the pharmacokinetics, efficacy and therapeutic plasma concentration of encainide, a new antiarrhythmic drug that affects His-Purkinje conduction but not ventricular refractoriness. Nine patients with frequent and complex premature ventricular complexes were studied in a 3-day double-blind protocol. Each day, each patient received 75 mg of i.v. or oral encainide or placebo. Frequent blood samples for encainide plasma concentration determination and continuous ambulatory ECGs were obtained. There was a marked intersubject variation in bioavailability (mean 42 +/- 24%, range 7.4-82%), clearance (13.2 +/- 5.6 ml/min/kg, range 3.75-22.1 ml/min/kg) and half-life (3.4 +/- 1.7 hours i.v., 2.5 +/- 0.8 hours oral). Eight of nine patients had more than 90% suppression of premature ventricular complexes for 3-36 hours. Minimal antiarrhythmic plasma concentration was higher (39 +/- 54 ng/ml, range 3.5-170 ng/ml) after i.v. dosing than after oral dosing (14 +/- 16 ng/ml, range 1.5-48 ng/ml), suggesting an active metabolite after oral dosing in many patients. Minimal side effects were seen despite high peak plasma concentrations (range 794-1556 ng/ml i.v., 36-495 ng/ml oral). The minimal ratio of toxic to therapeutic plasma concentration ranged from 4.3-326 (median 23) after oral dosing. Antiarrhythmic action was associated with an 11-44% widening of the QRS complex that was not associated with other adverse effects. We conclude that encainide effectively suppresses ventricular arrhythmias. Despite a variable bioavailability, high clearance and short half-life, its wide ratio of toxic to therapeutic concentration and probable active metabolite permit a long duration of action, which should allow a reasonable dose schedule in most patients during chronic oral dosing.
journal_name
Circulationjournal_title
Circulationauthors
Winkle RA,Peters F,Kates RE,Tucker C,Harrison DCdoi
10.1161/01.cir.64.2.290subject
Has Abstractpub_date
1981-08-01 00:00:00pages
290-6issue
2eissn
0009-7322issn
1524-4539journal_volume
64pub_type
临床试验,杂志文章相关文献
CIRCULATION文献大全abstract::The clinical use of citrate-phosphate-dextrose during blood-product transfusion is known to affect ionized calcium levels and can result in depression of myocardial contractility. The immature heart appears to have an intrinsic reduction in contractile state compared with the adult heart and may be more dependent on t...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:The incidence of pulmonary arterial hypertension secondary to the use of indirect serotinergic agonists such as aminorex and dexfenfluramine led to the "serotonin hypothesis" of pulmonary arterial hypertension; however, the role of serotonin in dexfenfluramine-induced pulmonary arterial hypertension remains ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.767558
更新日期:2008-06-03 00:00:00
abstract:BACKGROUND:The influence of changes in heart rate on myocardial contractility (the force-frequency effect) differs under various experimental conditions, including the anesthetized versus the conscious state. METHODS AND RESULTS:To assess the influence of beta-adrenergic stimulation on force-frequency effects on myoca...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.86.2.572
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:The novel phosphate binder sevelamer has been shown to prevent the progression of aortic and coronary calcification in uremic patients. Whether it also decreases the progression of atheromatous plaques is unknown. The aim of our study was to examine the effect of sevelamer administration on the development o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA105.541854
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The efficacy of bypass surgery in patients with ischemic cardiomyopathy is not easily predictable; preoperative clinical conditions may be similar, but the outcome may differ significantly. We hypothesized that the growth reserve of cardiac stem cells (CSCs) and circulating cytokines promoting CSC activation...
journal_title:Circulation
pub_type: 杂志文章,收录出版
doi:10.1161/CIRCULATIONAHA.113.006591
更新日期:2014-01-14 00:00:00
abstract:BACKGROUND:Influenza infection is a serious event for patients with heart failure (HF). Little knowledge exists about the association between influenza vaccination and outcome in patients with HF. This study sought to determine whether influenza vaccination is associated with improved long-term survival in patients wit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.036788
更新日期:2019-01-29 00:00:00
abstract::The quantitative approaches to the assessment of regional left ventricular (LV) function described in the preceding paper were applied in a well-defined population of patients with coronary artery disease. Two groups were chosen by electrocardiographic and angiographic criteria: group 1 had infarction and regional wal...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.4.761
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:Previous studies have documented the strong association between availability of on-site cardiac catheterization facilities and increased use of coronary angiography in patients with acute myocardial infarction (AMI). Although these studies have shown little influence of the availability of catheterization la...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.6.1770
更新日期:1997-09-16 00:00:00
abstract::Composite graft replacement of the ascending aorta and aortic valve was performed in 78 patients over an 8 1/2-year period. Degenerative lesions of the aortic root in Marfan's syndrome (annuloaortic ectasia) was the indication for operation in 56 cases; the other 22 patients had other causes of aortic root dilatation ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
abstract:BACKGROUND:Thirteen of 14 epidemiological studies have shown an increased risk of approximately 20% for coronary heart disease (CHD) for never-smokers exposed to environmental tobacco smoke (ETS), but this association remains controversial. If true, ETS might account for an estimated 35,000 to 40,000 heart disease deat...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.4.622
更新日期:1996-08-15 00:00:00
abstract:BACKGROUND:In patients with atrial fibrillation (AF), the risk of thromboembolic events (TEs) is variable and is influenced by the presence and number of comorbid conditions. The effect of percutaneous left atrial radiofrequency ablation (LARFA) of AF on the risk of TEs is unclear. METHODS AND RESULTS:LARFA was perfor...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.641225
更新日期:2006-08-22 00:00:00
abstract:BACKGROUND:Echocardiographically determined left ventricular hypertrophy (LVH) has a well-demonstrated association with cardiovascular morbidity and mortality. However, whether or not there is a sex differential in the impact of LVH on mortality has never been systematically explored. METHODS AND RESULTS:This study en...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.4.805
更新日期:1995-08-15 00:00:00
abstract:BACKGROUND:Hypertension decreases myocardial perfusion capacity in adults for several reasons, including insufficient coronary angiogenesis with left ventricular (LV) hypertrophy, arteriolar hypertrophy, and altered vasomotion. Heparin influences growth factors that promote angiogenesis and vasodilation and inhibit art...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.9.981
更新日期:1999-08-31 00:00:00
abstract:BACKGROUND:The pathophysiology of mental stress-induced myocardial ischemia, which occurs at lower heart rates than during physical stress, is not well understood. METHODS AND RESULTS:The Psychophysiological Investigations of Myocardial Ischemia Study (PIMI) evaluated the physiological and neuroendocrine functioning i...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.94.10.2402
更新日期:1996-11-15 00:00:00
abstract::Several conditions that contribute to drowning and near drowning must be considered in the treatment of near-drowned victims. Regardless of the cause, mechanical ventilation should begin as soon as possible and closed-chest cardiac massage should be administered when there is any question about the adequacy of cardiac...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract::The effect of timolol vs placebo on the frequency of anginal episodes, nitroglycerin consumption and exercise performance was investigated in a double-blind, randomized, crossover study in 23 patients with angina pectoris. The optimal dose of timolol (10-30 mg twice daily) for each patient was titrated by exercise stu...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.61.1.66
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:We attempted to characterize age-related changes in blood pressure in both normotensive and untreated hypertensive subjects in a population-based cohort from the original Framingham Heart Study and to infer underlying hemodynamic mechanisms. METHODS AND RESULTS:A total of 2036 participants were divided into...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.1.308
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Transplantation of ex vivo expanded circulating endothelial progenitor cells (EPCs) from peripheral blood mononuclear cells improves the neovascularization after critical ischemia. However, the origin of the endothelial progenitor lineage and its characteristics have not yet been clearly defined. Therefore, ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000096483.29777.50
更新日期:2003-11-18 00:00:00
abstract:BACKGROUND:Vascular inflammation and subsequent matrix degradation play an important role in the development of atherosclerosis. We previously reported that adiponectin, an adipose-specific plasma protein, accumulated to the injured artery and attenuated vascular inflammatory response. Clinically, high plasma adiponect...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000127953.98131.ED
更新日期:2004-05-04 00:00:00
abstract::We compared the effects of a cardioselective beta-adrenergic blocking drug, metoprolol, with a nonselective beta-adrenergic blocker, propranolol, on the response of 10 normal men to dynamic treadmill exercise. The volunteers underwent a standard graded exercise test to exhaustion while receiving placebo; propranolol, ...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.65.5.894
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:The introduction of limited approaches to the heart and the avoidance of cardiopulmonary bypass (CPB) aim to reduce the invasiveness of CABG by decreasing the systemic release of inflammatory cytokines, such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8, as well as the anti-inflammatory ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.102.suppl_3.iii-95
更新日期:2000-11-07 00:00:00
abstract:BACKGROUND:Previous studies have shown that hypertrophy of surviving myocytes after myocardial infarction (MI) is limited. Progressive ventricular dilatation after MI may occur when compensatory hypertrophy cannot restore left ventricular (LV) wall stress to normal. METHODS AND RESULTS:To test whether induction of add...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.4.1819
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Extrahepatic tissues have long been considered critical contributors of cholesterol to nascent HDL particles in the reverse cholesterol transport pathway, in which ABCA1 plays the crucial role. Recent studies, however, including both overexpression and deletion of ABCA1 selectively in the liver, have highlig...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.621433
更新日期:2006-09-19 00:00:00
abstract:BACKGROUND:An objective of the United States' Healthy People 2010 Initiative is to eliminate disparities based on socioeconomic status. We assessed the effect of difficulty affording health care on the health status (symptoms, function, and quality of life) of patients treated with percutaneous coronary intervention or...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.474775
更新日期:2005-05-24 00:00:00
abstract::Ten subjects with normal hemodynamics were studied during elective cardiac catheterization with right and left heart multisensor micromanometry to assess hemodynamic responses to the Mueller maneuver. Simultaneous right and left circulatory hemodynamics and left ventricular, pulmonary arterial, and aortic pressures we...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.76.5.1020
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Tumor necrosis factor alpha (TNF-alpha) increases in patients with severe congestive heart failure (CHF) and cachexia. Two naturally occurring modulators of TNF-alpha activity have been identified in human serum. These two soluble proteins are the extracellular domains of the TNF receptors (sTNF-RI and sTNF-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.6.1479
更新日期:1995-09-15 00:00:00
abstract:BACKGROUND:Nuclear reprogramming provides an emerging strategy to produce embryo-independent pluripotent stem cells from somatic tissue. Induced pluripotent stem cells (iPS) demonstrate aptitude for de novo cardiac differentiation, yet their potential for heart disease therapy has not been tested. METHODS AND RESULTS:...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.865154
更新日期:2009-08-04 00:00:00
abstract::Coronary artery bypass grafts, angioplasty, and thrombolysis are beneficial procedures for patients with coronary artery disease. However, these procedures can fail by mechanisms related to interactions between platelets and the damaged arterial wall. An experimental model for studying some of the mechanisms of platel...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Diffuse coronary artery disease is frequently untreatable by coronary artery bypass or angioplasty. Many such "no-option" patients have been subjects for trials of angiogenesis using growth factor manipulation or laser injury. We think these novel revascularization strategies are limited by insufficient inflow to puta...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.21.2539
更新日期:2001-05-29 00:00:00
abstract::R-wave synchronous equilbrium radionuclide angiography (RNA) is a noninvasive method that provides time-activity curve count information proportional to ventricular volumes and is used for relative volume comparisons within the left or right ventricle to derive the ejection fraction. Comparison of the ventricular coun...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.62.5.1089
更新日期:1980-11-01 00:00:00