Mammohansingh P, Parker J O
Am Heart J. 1975 Nov;90(5):555-61. doi: 10.1016/0002-8703(75)90217-3.
Seventeen subjects ranging from 36 to 58 years of age presented with chest pain suggestive of myocardial ischemia. Each patient had a positive double Master's two-step test with ST segment depression of 0.5 mm. or more in the postexercise ECG. In each case coronary angiography and left ventriculography were normal. Hemodynamic and metabolic investigations were carried out during sinus rhythm and atrial pacing. Thirteen patients experienced pain during pacing but only one showed an abnormal hemodynamic response. Two patients showed abnormal myocardial lactate metabolism during the control period and four during pacing-induced tachycardia. The increase in ejection fractions in this group suggests hyperdynamic ventricular contraction which could result in increased oxygen requirements and thus induce ischemic pain in the absence of arteriographically demonstrable coronary artery disease.
17名年龄在36至58岁之间的受试者出现提示心肌缺血的胸痛症状。每位患者运动后心电图的双倍二级梯运动试验均呈阳性，ST段压低0.5毫米或更多。在每种情况下，冠状动脉造影和左心室造影均正常。在窦性心律和心房起搏期间进行了血流动力学和代谢研究。13名患者在起搏期间出现疼痛，但只有1名患者表现出异常的血流动力学反应。2名患者在对照期出现异常的心肌乳酸代谢，4名患者在起搏诱发的心动过速期间出现异常。该组射血分数的增加提示心室收缩功能亢进，这可能导致氧需求增加，从而在没有动脉造影可证实的冠状动脉疾病的情况下诱发缺血性疼痛。
