Hellstrom H R
Am Heart J. 1977 Nov;94(5):642-8. doi: 10.1016/s0002-8703(77)80136-1.
The injury-vasospasm hypothesis of IHD was discussed in relation to coronary artery autoregulation and the anoxic-feedback mechanism. Observations in the recent literature, not usually attributed to spasm, were examined in light of this phenomenon. This includes reperfusion models of experimental AMI, the association of AMI with myocarditis, and findings in AMI and SCD as necrotic microlesions, prodromata, and epicardial arterial plaque rupture and hemorrhage. The disparity between the severity of coronary disease and the occurrence of the various types of IHD suggest that atherosclerosis itself does not precipitate attacks of chest pain. It was emphasized that plaque rupture due to spasm might help induce CAT. With exercise, the possible importance of the autoregulatory system was explored in the prevention and induction of AMI and SCD, and the improvement of AP. The role of spasm in IHD should be defined.
关于冠状动脉自动调节和缺氧反馈机制，讨论了缺血性心脏病的损伤-血管痉挛假说。根据这一现象，对近期文献中通常未归因于痉挛的观察结果进行了研究。这包括实验性急性心肌梗死的再灌注模型、急性心肌梗死与心肌炎的关联，以及急性心肌梗死和心源性猝死中坏死性微病变、前驱症状、心外膜动脉斑块破裂和出血的发现。冠状动脉疾病的严重程度与各种类型缺血性心脏病的发生之间的差异表明，动脉粥样硬化本身不会引发胸痛发作。强调因痉挛导致的斑块破裂可能有助于诱发冠状动脉血栓形成。通过运动，探讨了自动调节系统在预防和诱发急性心肌梗死和心源性猝死以及改善心绞痛方面的潜在重要性。应明确痉挛在缺血性心脏病中的作用。
