Yun Kyeong Ho, Shin Seoung-Nam, Ko Jum Suk, Rhee Sang Jae, Kim Nam-Ho, Oh Seok Kyu, Jeong Jin-Won
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Republic of Korea.
Int Heart J. 2011;52(6):338-42. doi: 10.1536/ihj.52.338.
Even patients without vasospastic angina show vasoconstriction after intracoronary ergonovine administration. We evaluated the determinants of coronary artery responsiveness to ergonovine in such patients.In 165 patients with no provoked electrocardiographic changes or ischemic chest pain during an intracoronary ergonovine test, total cholesterol, triglycerides (TG), high density lipoprotein cholesterol (HDL), and low density lipoprotein cholesterol (LDL) were correlated with the arterial luminal diameters before and after ergonovine infusion and after nitroglycerin injection by quantitative coronary angiography analysis.The mean and maximal basal tone (ie, percent change between baseline luminal diameter and diameter after nitroglycerin) were 7.0 ± 9.9% and 27.9 ± 10.8%, respectively. The mean and maximal responsiveness to ergonovine (ie, percent change between minimal diameter during ergonovine infusion and diameter after nitroglycerin) were 30.3 ± 13.6% and 52.7 ± 16.0%, respectively. The TG level (r = 0.191, P = 0.016) and TG/HDL ratio (r = 0.182, P = 0.021) were positively correlated with the basal tone, whereas LDL level (r = 0.155, P = 0.048) and LDL/HDL ratio (r = 0.172, P = 0.030) were positively correlated with the responsiveness to ergonovine. By multivariate analysis, LDL level, LDL/HDL ratio, and smoking were independent predictors of more than 50% responsiveness to ergonovine.Serum lipid profile and smoking influence the basal tone and responsiveness to ergonovine of coronary artery in patients without vaospastic angina.
即使没有血管痉挛性心绞痛的患者在冠状动脉内注射麦角新碱后也会出现血管收缩。我们评估了此类患者冠状动脉对麦角新碱反应性的决定因素。在165例冠状动脉内麦角新碱试验期间未诱发心电图改变或缺血性胸痛的患者中，通过定量冠状动脉造影分析，总胆固醇、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL）和低密度脂蛋白胆固醇（LDL）与麦角新碱输注前后以及硝酸甘油注射后的动脉管腔直径相关。平均基础张力和最大基础张力（即基线管腔直径与硝酸甘油后直径之间的百分比变化）分别为7.0±9.9%和27.9±10.8%。对麦角新碱的平均反应性和最大反应性（即麦角新碱输注期间最小直径与硝酸甘油后直径之间的百分比变化）分别为30.3±13.6%和52.7±16.0%。TG水平（r = 0.191，P = 0.016）和TG/HDL比值（r = 0.182，P = 0.021）与基础张力呈正相关，而LDL水平（r = 0.155，P = 0.048）和LDL/HDL比值（r = 0.172，P = 0.030）与对麦角新碱的反应性呈正相关。通过多变量分析，LDL水平、LDL/HDL比值和吸烟是对麦角新碱反应性超过50%的独立预测因素。血清脂质谱和吸烟会影响无血管痉挛性心绞痛患者冠状动脉的基础张力和对麦角新碱的反应性。
