Quyyumi A A, Raphael M, Perrins E J, Shapiro L M, Rickards A F, Fox K M
Br Heart J. 1986 Jul;56(1):27-32. doi: 10.1136/hrt.56.1.27.
The incidence of coronary artery spasm at the site of previous successful angioplasty and its importance in leading to subsequent restenosis or recurrence of symptoms are unknown. Fourteen consecutive patients with single vessel coronary artery disease who had undergone successful percutaneous transluminal angioplasty were studied. All patients were given ergometrine maleate (ergonovine maleate) intravenously during repeat cardiac catheterisation six weeks to three months after angioplasty. Five patients demonstrated excessive luminal reduction (spasm) at the site of previous angioplasty that led to luminal stenoses ranging from 50% to 79%. Two of these patients developed chest pain and ST segment changes during ergometrine maleate provocation and they also showed maximal vasoconstriction. The remaining nine patients did not develop important luminal change at the site of angioplasty after ergometrine maleate. Ergometrine maleate administration resulted in less than or equal to 20% reduction in lumen diameter of adjacent apparently normal sections of the coronary arteries in all but two patients. At the site of previous angioplasty in the five patients with spasm, however, the lumen was constricted by a mean (SD) of 51 (12)%, whereas in the nine patients not demonstrating spasm mean reduction was 12 (7)%. Thus hypersensitivity to ergometrine maleate at the site of previous successful angioplasty was demonstrated in over a third of consecutive patients with single vessel coronary artery disease. The importance of this finding to long term results of coronary angioplasty needs to be investigated further.
既往成功进行血管成形术部位的冠状动脉痉挛发生率及其在导致随后再狭窄或症状复发中的重要性尚不清楚。对14例连续的单支冠状动脉疾病患者进行了研究，这些患者均成功接受了经皮腔内血管成形术。所有患者在血管成形术后6周3个月进行重复心导管检查时静脉注射马来酸麦角新碱（马来酸麦角诺文）。5例患者在既往血管成形术部位出现管腔过度缩小（痉挛），导致管腔狭窄50%79%。其中2例患者在注射马来酸麦角新碱激发试验时出现胸痛和ST段改变，且显示出最大血管收缩。其余9例患者在注射马来酸麦角新碱后，血管成形术部位未出现明显管腔改变。除2例患者外，注射马来酸麦角新碱后，所有患者冠状动脉相邻看似正常节段的管腔直径缩小均≤20%。然而，在5例出现痉挛的患者既往血管成形术部位，管腔平均（标准差）收缩51（12）%，而在9例未出现痉挛的患者中，平均缩小为12（7）%。因此，超过三分之一的连续单支冠状动脉疾病患者在既往成功进行血管成形术的部位对马来酸麦角新碱表现出超敏反应。这一发现对冠状动脉成形术长期结果的重要性有待进一步研究。
