Muto Mitsuru, Saitoh Shu-Ichi, Osugi Taku, Matsumoto Ken, Aikawa Kazuhiko, Onogi Futoshi, Ishibashi Toshiyuki, Maruyama Yukio
Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan.
Coron Artery Dis. 2006 Nov;17(7):629-35. doi: 10.1097/01.mca.0000236283.64059.70.
The purpose of this study is to assess the effect of beta1-selective blocker on coronary vasospasm.
Balloon epicardial coronary artery endothelial denudation was performed at the left anterior descending coronary artery every 2 weeks for a total of 4 times in pigs. Changes in denuded site diameter and left anterior descending coronary artery blood flow caused by acetylcholine or serotonin were assessed before each endothelial denudation and at week 8 in untreated pigs (ED group) and in those treated with metoprolol (Meto group) or propranolol (Pro group).
In the ED group, decreased blood flow response to acetylcholine enhanced from -20+/-10% before the first ED to -100% (i.e. zero flow) at week 8 without denuded site narrowing, suggesting microvascular spasm, and serotonin-induced left anterior descending coronary artery diameter reduction at week 8 was -92+/-15%. In the Pro group, blood flow reduction by acetylcholine and left anterior descending coronary artery diameter reduction by serotonin did not change compared with those of the ED group. In the Meto group however, blood flow reduction by acetylcholine (week 8, -70+/-16%) and left anterior descending coronary artery diameter reduction by serotonin (week 8, -64+/-15%) were blunted (P<0.01) compared with those of ED and Pro groups.
The beta1-selective blocker metoprolol was effective to prevent coronary vasospasm.
本研究旨在评估β1 选择性阻滞剂对冠状动脉痉挛的影响。
每隔 2 周对猪的左前降支冠状动脉进行一次球囊心外膜冠状动脉内皮剥脱术，共进行 4 次。在未治疗的猪（内皮剥脱组，ED 组）以及用美托洛尔（美托组，Meto 组）或普萘洛尔（普萘组，Pro 组）治疗的猪中，在每次内皮剥脱术前以及第 8 周时评估乙酰胆碱或血清素引起的剥脱部位直径和左前降支冠状动脉血流的变化。
在 ED 组中，对乙酰胆碱的血流反应降低从第一次内皮剥脱术前的-20±10%增强至第 8 周时的-100%（即血流为零），且剥脱部位无狭窄，提示微血管痉挛，第 8 周时血清素引起的左前降支冠状动脉直径缩小为-92±15%。在 Pro 组中，与 ED 组相比，乙酰胆碱引起的血流减少和血清素引起的左前降支冠状动脉直径缩小无变化。然而，在 Meto 组中，与 ED 组和 Pro 组相比，乙酰胆碱引起的血流减少（第 8 周，-70±16%）和血清素引起的左前降支冠状动脉直径缩小（第 8 周，-64±15%）减弱（P<0.01）。
β1 选择性阻滞剂美托洛尔可有效预防冠状动脉痉挛。
