Simonetti I, Michelassi C, De Caterina R, Marzilli M, L'Abbate A
CNR Institute of Clinical Physiology, Pisa, Italy.
Am Heart J. 1989 Feb;117(2):323-31. doi: 10.1016/0002-8703(89)90775-8.
The time course of the vasodilation of different segments of the epicardial coronary vasculature after three different doses of intracoronary isosorbide dinitrate (ISDN) was investigated in angiographically normal coronary arteries in 10 patients with quantitative coronary angiography. In five patients, 0.1 mg and 0.3 mg ISDN were injected intracoronary 30 minutes apart, and the effect of each dose was assessed at 1, 5, 10, and 15 minutes after the administration by serial angiograms. In five additional patients, a single dose of 3 mg was injected and coronary vasodilation was assessed at 1, 5, 10, 15, and 20 minutes. After each dose, dilation of epicardial coronary arteries occurred within 1 minute, peaked at 5 minutes and progressively decreased thereafter. Relative to control, peak percent diameter increase was (mean +/- SEM) 10% +/- 0.9% (p less than 0.01), 18.5% +/- 1.5% (p less than 0.01), and 26% +/- 2.1% (p less than 0.01) after 0.1, 0.3, and 3.0 mg, respectively. When small (1 to 2 mm), medium (2 to 3 mm), and large (greater than 3 mm) vessels were separately analyzed, peak response was respectively 12% +/- 1.3% (p less than 0.01), 9% +/- 1.9% (p less than 0.01), and 7% +/- 1% (p less than 0.05) after 0.1 mg ISDN; 22% +/- 1.8% (p less than 0.01), 16% +/- 1.3% (p less than 0.01), and 12% +/- 0.8% (p less than 0.01) after 0.3 mg; and 38% +/- 2.4% (p less than 0.01), 22% +/- 2.1% (p less than 0.01), and 17% +/- 2% (p less than 0.01) after 3.0 mg. The duration of the response increased with the dose, but was inversely related to the size of the vessel.(ABSTRACT TRUNCATED AT 250 WORDS)
在10例冠状动脉造影正常的患者中，通过定量冠状动脉造影研究了三种不同剂量的冠状动脉内注射硝酸异山梨酯（ISDN）后心外膜冠状动脉不同节段血管舒张的时间过程。在5例患者中，相隔30分钟冠状动脉内注射0.1mg和0.3mg ISDN，并在给药后1、5、10和15分钟通过系列血管造影评估各剂量的效果。在另外5例患者中，注射单剂量3mg，并在1、5、10、15和20分钟评估冠状动脉血管舒张情况。每次给药后，心外膜冠状动脉在1分钟内发生舒张，在5分钟时达到峰值，此后逐渐下降。相对于对照，0.1mg、0.3mg和3.0mg后直径增加的峰值百分比分别为（均值±标准误）10%±0.9%（p<0.01）、18.5%±1.5%（p<0.01）和26%±2.1%（p<0.01）。当分别分析小（1至2mm）、中（2至3mm）和大（大于3mm）血管时，0.1mg ISDN后峰值反应分别为12%±1.3%（p<0.01）、9%±1.9%（p<0.01）和7%±1%（p<0.05）；0.3mg后分别为22%±1.8%（p<0.01）、16%±1.3%（p<0.01）和12%±0.8%（p<0.01）；3.0mg后分别为38%±2.4%（p<0.01）、22%±2.1%（p<0.01）和17%±2%（p<0.01）。反应持续时间随剂量增加，但与血管大小呈负相关。（摘要截短至250字）
