Simon R, Koch M, Reil G H, Herrmann G, Amende I, Quante W, Lichtlen P R
Department of Cardiology, Hannover Medical School, F.R.G.
Eur Heart J. 1988 Jan;9 Suppl A:89-93. doi: 10.1093/eurheartj/9.suppl_a.89.
The effects of 0.2 mg nitroglycerin administered directly into the left coronary artery were studied in 7 patients with coronary artery disease. A multipurpose catheter designed for simultaneous measurement of coronary sinus flow and great cardiac vein flow by thermodilution and for addition recording of dye dilution curves by a fiberoptic method was introduced from a right antecubital vein into the coronary sinus and advanced with its tip to the great cardiac vein/anterior cardiac vein juncture. Coronary sinus flow and great cardiac vein flow were measured using the constant infusion technique. Selective bolus injections of indocyanine green dye were measured using the constant infusion technique. Selective bolus injections of indocyanine green dye were performed into the left coronary system via a 8 French Judkins catheter and dye dilution curves were recorded in the upper great cardiac vein. From these curves, coronary transit time was assessed and coronary vascular volume was calculated as great cardiac vein flow times coronary transit time. Intracoronary nitroglycerin led to a transient drop in regional coronary resistance that was associated with an almost parallel increase in intravascular volume. Since this increase in coronary vascular volume exceeded the well-known dilatory effect on the epicardial arteries, and lasted slightly longer than the drop in regional resistance, these data imply that the vasodilatory action of nitroglycerin is different in magnitude as well as in time course in different parts of the coronary circulation.
对7例冠状动脉疾病患者研究了直接向左冠状动脉内注射0.2mg硝酸甘油的效果。一种多功能导管从右肘前静脉插入冠状窦，该导管设计用于通过热稀释法同时测量冠状窦血流和心大静脉血流，并通过光纤法额外记录染料稀释曲线，其尖端推进至心大静脉/心前静脉交界处。使用恒速输注技术测量冠状窦血流和心大静脉血流。通过8F Judkins导管向左冠状动脉系统选择性推注吲哚菁绿染料，并在心大静脉上部记录染料稀释曲线。根据这些曲线评估冠状动脉通过时间，并将冠状血管容积计算为心大静脉血流乘以冠状动脉通过时间。冠状动脉内注射硝酸甘油导致局部冠状动脉阻力短暂下降，这与血管内容积几乎平行增加有关。由于冠状血管容积的这种增加超过了对心外膜动脉的众所周知的扩张作用，并且持续时间略长于局部阻力的下降，这些数据表明硝酸甘油在冠状动脉循环不同部位的血管扩张作用在程度和时间过程上是不同的。
