Crake T, Lindsay D C, Poole-Wilson P A
Department of Cardiac Medicine, National Heart and Lung Institute, London, UK.
Cardioscience. 1990 Jun;1(2):119-26.
The concentration of potassium ions, [K+], in the blood of the coronary sinus was recorded using catheter-tip potassium ion-selective electrodes during fixed rate atrial pacing for up to six minutes in five patients with normal hearts (control group) and in eight with coronary artery disease. Four patients with coronary artery disease developed pain in the chest and changes on the electrocardiogram during atrial pacing (ischemic group). In the control group, the coronary sinus [K+] began to rise after three seconds to a peak increase of 0.33 +/- 0.04 mmol.l-1 (p less than 0.001) and then returned to the resting value. On cessation of pacing, coronary sinus [K+] fell rapidly and transiently below the resting value. In the ischemic group, the coronary sinus [K+] began to rise after three seconds to a peak of 0.42 +/- 0.05 mmol.l-1 (p less than 0.01); it remained elevated throughout the period of atrial pacing (p less than 0.01) and fell rapidly and transiently below the resting value on cessation of pacing. Four patients with coronary artery disease did not develop ST segment depression during atrial pacing; in two the changes in coronary sinus [K+] were the same as those in the ischemic group, and in two they were similar to those in the control group. These data show that in man there is an immediate and transient loss of potassium from the myocardial cells when the heart rate is increased and that this loss is restored the heart rate returns to the resting rate. Myocardial ischemia causes a continuing efflux of potassium from myocardial cells.(ABSTRACT TRUNCATED AT 250 WORDS)
在五名心脏正常的患者（对照组）和八名冠状动脉疾病患者中，使用导管尖端钾离子选择性电极在固定频率心房起搏长达六分钟的过程中记录冠状窦血液中的钾离子浓度[K+]。四名冠状动脉疾病患者在心房起搏期间出现胸痛和心电图变化（缺血组）。在对照组中，冠状窦[K+]在三秒后开始上升，峰值增加0.33±0.04 mmol·l-1（p<0.001），然后恢复到静息值。起搏停止后，冠状窦[K+]迅速下降并短暂低于静息值。在缺血组中，冠状窦[K+]在三秒后开始上升，峰值为0.42±0.05 mmol·l-1（p<0.01）；在心房起搏期间一直保持升高（p<0.01），起搏停止后迅速下降并短暂低于静息值。四名冠状动脉疾病患者在心房起搏期间未出现ST段压低；其中两名患者冠状窦[K+]的变化与缺血组相同，另外两名患者与对照组相似。这些数据表明，在人类中，当心率增加时心肌细胞会立即出现短暂的钾离子丢失，并且当心率恢复到静息心率时这种丢失会恢复。心肌缺血会导致心肌细胞持续外流钾离子。（摘要截断于250字）
