Harris P
Eur J Cardiol. 1975 Aug;3(2):157-63.
Evidence is discussed which suggests that coronary arterial thrombosis need not be the primary event in myocardial infarction. If this is so, it is necessary to consider the initial changes which might occur in the myocardium rather than the effects of experiments in which the coronary arterial supply has been suddenly cut off. Results of recent investigations on patients suggest that, during the anginal attack, there is an inability of the affected myocardium to relax and a diminution in the flow of blood to the region. The former implies an increased myofibrillar concentration of calcium ions, the latter may be explained by the mechanical compression of small intramyocardial blood vessels. It is argued that these two factors may initiate vicious circles which could lead to the death of myocardial cells and thus to myocardial infarction.
有证据表明，冠状动脉血栓形成不一定是心肌梗死的首要事件。如果真是这样，就有必要考虑心肌可能发生的初始变化，而不是冠状动脉供血突然中断的实验所产生的影响。近期对患者的调查结果表明，在心绞痛发作期间，受累心肌无法舒张，该区域的血流减少。前者意味着肌原纤维中钙离子浓度增加，后者可能是由于心肌内小血管受到机械性压迫所致。有人认为，这两个因素可能引发恶性循环，进而导致心肌细胞死亡，从而引发心肌梗死。
