Tousoulis D, Kaski J C, Bogaty P, Crea F, Gavrielides S, Galassi A R, Maseri A
Cardiovascular Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Am J Cardiol. 1991 Jun 1;67(15):1195-200. doi: 10.1016/0002-9149(91)90926-c.
To assess whether vasoreactivity of significant coronary stenosis (greater than 50% intraluminal diameter reduction) and that of angiographically normal coronary segments differs in proximal and distal locations, 53 patients (40 men, 13 women, mean +/- standard deviation age 55 +/- 11 years) with chronic stable angina and angiographically documented coronary artery disease were studied. While abstaining from antianginal therapy, all 53 patients underwent coronary arteriography before and after 1 mg of intracoronary isosorbide dinitrate and 21 of the 53 also before and after 20 to 30 micrograms intracoronary ergonovine. Computerized quantitative angiography was used to assess changes in the intraluminal diameter of 126 normal coronary segments (63 proximal, 63 distal) and 43 significant coronary stenoses. Nitrates dilated proximal normal coronary segments by 7.4 +/- 1.2% and distal normal coronary segments by 15 +/- 1.7% (p less than 0.01). Significant proximal coronary stenoses dilated by 11 +/- 2.5% and distal stenoses by 23 +/- 2.8% (p less than 0.01) after nitrates. Ergonovine reduced the diameter of proximal normal coronary segments by 9.3 +/- 1.7% and that of normal distal segments by 15.5 +/- 1.4% (p less than 0.01). Proximal stenoses constricted by 11 +/- 2.2% and distal stenoses by 18.4 +/- 2.8% (p = 0.06). Analysis of segments showed that nitrates dilated 19 of 63 (30%) proximal normal segments by (greater than or equal to 10%), 31 of 63 (49%) distal (p less than 0.05) and 21 of 43 (49%) stenoses.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估严重冠状动脉狭窄（管腔直径减少大于50%）与造影显示正常的冠状动脉节段在近端和远端位置的血管反应性是否存在差异，对53例（40例男性，13例女性，平均年龄55±11岁）慢性稳定型心绞痛且有冠状动脉造影记录的冠心病患者进行了研究。在停用抗心绞痛治疗的情况下，所有53例患者在冠状动脉内注射1毫克硝酸异山梨酯前后均接受了冠状动脉造影，53例中的21例在冠状动脉内注射20至30微克麦角新碱前后也接受了造影。采用计算机定量血管造影评估126个正常冠状动脉节段（63个近端，63个远端）和43处严重冠状动脉狭窄的管腔直径变化。硝酸盐使近端正常冠状动脉节段扩张7.4±1.2%，远端正常冠状动脉节段扩张15±1.7%（p<0.01）。硝酸盐作用后，严重近端冠状动脉狭窄扩张11±2.5%，远端狭窄扩张23±2.8%（p<0.01）。麦角新碱使近端正常冠状动脉节段直径减少9.3±1.7%，正常远端节段减少15.5±1.4%（p<0.01）。近端狭窄收缩11±2.2%，远端狭窄收缩18.4±2.8%（p=0.06）。节段分析显示，硝酸盐使63个近端正常节段中的19个（30%）扩张（≥10%），63个远端节段中的31个（49%）扩张（p<0.05），43处狭窄中的21个（49%）扩张。（摘要截选至250字）
