在运动期间出现冠状动脉异常的冠状动脉运动,冠状动脉正常,冠状动脉流量储备减少的患者
A S Bortone1, O M Hess, F R Eberli
1Medical Policlinic, Division of Cardiology, University Hospital, Zürich, Switzerland.
Circulation
|March 1, 1989
概括
患有胸痛和正常动脉的患者可能有异常的冠状动脉血管活性. 有些人在运动期间表现出远部血管收缩,这表明一种异常的冠状动脉血管扩张综合征可能与神经和性因素有关.
科学领域:
- 心脏病学 心脏病学
- 血管生理学 血管生理学
背景情况:
- 尽管冠状动脉正常,但患有缺血样症状的患者观察到冠状动脉流量储备的减少.
- 了解这些患者冠状动脉血管运动异常的潜在机制对于诊断和治疗至关重要.
研究的目的:
- 在患有缺血样症状和正常冠状动脉的患者中调查冠状动脉运动和流量储备.
- 确定冠状动脉血管对生理和药理刺激的反应的不同模式.
主要方法:
- 使用定量冠状动脉造影来评估对运动和酸甘的反应中的光线区域变化.
- 冠状动脉鼻腔的血流被测量使用热稀释在dipiridamole输液后.
- 根据运动期间的冠状动脉反应 (血管扩张与血管收缩) 将患者分为几组.
主要成果:
- 七名患者 (第一组) 在炼期间和酸甘油后,在近心和远心冠状动脉中表现出血管扩张.
- 六名患者 (第二组) 在运动期间表现出远部冠状动脉静脉收缩,与近端血管扩张,并在二皮里达摩尔后减少了流量储备.
- 第1组的冠状动脉流量比为2.5,而第2组的冠状动脉流量比为1.2 (p<0.05).
结论:
- 一部分患有冠状动脉正常和缺血症状的患者表现出异常扩张器反应,特别是运动期间的远部血管收缩.
- 这个群体 (异常冠状动脉血管扩张综合征) 显示出经二皮里达摩尔后阻力血管能力受损.
- 这些发现表明,神经道度异常在运动诱导的偏远冠状动脉静脉收缩和的血管反应中可能起作用.
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