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Kokyu to Junkan Volume 43, Issue 1 （January 1995）

呼吸と循環 43巻1号（1995年1月発行）

Japanese English

研究

心室性期外収縮の日内変動に与えるpropafenone食後投与の効果 Effect of Postprandial Administration of Propafenone on Diurnal Variation of Premature Ventricular Contractions 堀本和志 ¹ , 藤原正文 ¹ , 古口健一 ² , 五十嵐慶一 ² , 竹中孝 ² Masashi Horimoto ¹ , Masafumi Fujiwara ¹ , Ken-ichi Koguchi ² , Keiichi Igarashi ² , Takashi Takenaka ² ¹国立札幌病院循環器科 ²石狩病院内科 ¹Division of Cardiology, Sapporo National Hospital ²Division of Internal Medicine, Ishikari Hospital キーワード：プロパフェノン , 食後投与 , 心室性期外収縮 , 口内変動 , propafenone , postprandial administration , premature ventricular contractions , diurnal variation Keyword: プロパフェノン , 食後投与 , 心室性期外収縮 , 口内変動 , propafenone , postprandial administration , premature ventricular contractions , diurnal variation pp.55-60

発行日 1995年1月15日 Published Date 1995/1/15

DOI https://doi.org/10.11477/mf.1404900988

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Abstract 文献概要
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　Propafenone（PF）の食後投与が心室性期外収縮（PVC）の日内変動に与える影響，特に夜間PVCの抑制について検討するため，1日3,000より多いPVCを有する患者22名を対象に，PFを食後3回投与（450mg／日）し，PF投与の前後で24時間ホルター心電図記録を施行した．PF投与後に1日PVC総数は75.2±5.9％（平均±標準誤差）減少した．PF投与前のPVC日内変動は昼型，夜型と全日型に分類され，昼型と夜型ではPF投与後の日中（7〜22時）と夜間（22〜7時）の時間あたりPVC頻度に有意差はなく，PVCの日内変動は消失した．PF投与前に対する投与後のPVC頻度の比率は，昼型の日中で28.5土9.9％（平均±標準偏差），夜間で77.0±32.4％，夜型の日中で19.5±9.7％，夜間で13.6±8.1％，全日型の日中で8.9±4.5％，夜間で40.9±15.9％であり，各型での日中と夜間の上記比率に有意差はなく，PF 450 mg／日の食後3回投与はPVCの日内変動を消失させ，日中と同様に夜間のPVCも十分に抑制すると判断した．

Diurnal variation of premature ventricular contrac-tions (PVCs) and the effect on the variation of post-prandial administration of propafenone (PF) was stud-ied in 22 patients with PVCs ＞ 3000/day. PF was administered with 150mg three times a day. Ambu-latory 24-hour Holter monitoring was performed beforeand after the administration of PF.

Daily total PVCs were reduced by 75.2±5.9% (mean±SE) after the administration of PF. Three types of diurnal variation of PVCs, daytime, nocturnal and all-day patterns, were demonstrated before the drug was administered. Postprandial administration of PF abolished the diurnal variation of PVCs in the daytime and in the nocturnal patterns. The ratios of the daytime frequency of PVCs at the postmedication period to premedication period were 28.5% in the day-time pattern, 19.5% in the nocturnal pattern and 8.9% in the all-day pattern. Whereas, the ratios of the noctur-nal frequency of PVCs at the postmedication period to premedication period were 77.0% in the daytime pat-tern, 13.6% in the nocturnal pattern and 40.9% in the all -day patter. No significant differences were noted between the percent ratios in the day-time and at night.

This data indicate that the postprandial administra-tion of PF favorably suppressed PVCs at night as well as in the daytime despite the relatively short elimina-tion half-life of PF. According to the literature, percent reduction of PVCs after 8-hourly administration of PF was 82.0 or 87.2%. This value is higher than the percent reduction obtained by postprandial administration of PF. Thus the previous suggestion is unlikely to be supported that the bioavailability of PF is increased with its postprandial administration.