Mudge G H, Grossman W, Mills R M, Lesch M, Braunwald E
N Engl J Med. 1976 Dec 9;295(24):1333-7. doi: 10.1056/NEJM197612092952401.
To assess possible coronary vasoconstriction in patients with ischemic heart disease, we measured coronary vascular resistance in 12 patients with normal hearts and 12 with coronary disease before and during the initial 50 seconds of cold pressor test, a stimulus known to produce systemic vasoconstriction. Control coronary vascular resistance was similar in the two groups, and although it did not change in patients with normal vessels, it rose by 27 per cent (P less than 0.005) in the group with coronary disease during the cold pressor test. In three of 12 patients with coronary disease coronary flow actually declined despite an increase in arterial pressure; in four, angina was precipitated. Phentolamine abolished increases in arterial pressure and coronary vascular resistance during the test in three patients with coronary disease. Adrenergically mediated coronary vascular tone may be an important determinant of coronary blood flow and may contribute to ischemia in patients with coronary disease.
为评估缺血性心脏病患者可能存在的冠状动脉血管收缩情况，我们在12例心脏正常的患者和12例冠心病患者中，于冷加压试验最初50秒之前及期间测量了冠状动脉血管阻力，冷加压试验是一种已知可引起全身血管收缩的刺激。两组的对照冠状动脉血管阻力相似，正常血管的患者其阻力未发生变化，而冠心病组在冷加压试验期间阻力升高了27%（P<0.005）。12例冠心病患者中有3例尽管动脉压升高，但冠状动脉血流实际却下降；4例诱发了心绞痛。酚妥拉明消除了3例冠心病患者试验期间的动脉压升高及冠状动脉血管阻力增加。肾上腺素介导的冠状动脉血管张力可能是冠状动脉血流的重要决定因素，并可能导致冠心病患者的心肌缺血。
