Suematsu M, Ito Y, Fukuzaki H
Department of Internal Medicine, Kobe University School of Medicine, Japan.
Jpn Heart J. 1987 Sep;28(5):649-61. doi: 10.1536/ihj.28.649.
To evaluate the role of the autonomic nervous system, especially the parasympathetic nervous system, in the initiation mechanism of vasospastic angina pectoris (AP), the coefficient of R-R interval variation (CV) on the electrocardiogram (ECG) and plasma catecholamine concentration were measured in 25 patients with vasospastic AP, 10 patients with effort AP and 12 control subjects. CV which has been recognized as reflecting parasympathetic nervous system activity was calculated from 100 consecutive heart beats on the ECG and represented as the percentage of standard deviation of the R-R interval per mean R-R interval. Repeated measurements of plasma catecholamine concentration revealed higher values at any sampling point throughout a day in patients with vasospastic AP than those in control subjects. A distinctly higher CV was observed at night in the vasospastic AP group. This elevated CV was abolished by atropine sulfate (1.5 mg/day per os). Pilocarpine injection (1.3 mg/10 kg B.W. subcutaneously) induced a marked increase in CV that preceded the occurrence of chest pain and/or ischemic ECG changes in 5 patients with vasospastic AP. The increment in CV at 10 min after pilocarpine administration was greater in vasospastic AP than in control subjects (p less than 0.05). It is concluded that enhanced parasympathetic activity may play a role in the initiation of coronary vasospasm associated with sympathetic hyperactivity.
为评估自主神经系统尤其是副交感神经系统在变异性心绞痛（AP）发作机制中的作用，对25例变异性AP患者、10例劳力性AP患者及12名对照者进行了心电图（ECG）上R-R间期变异系数（CV）及血浆儿茶酚胺浓度测定。CV被认为可反映副交感神经系统活动，由ECG上连续100次心跳计算得出，以R-R间期标准差占平均R-R间期的百分比表示。血浆儿茶酚胺浓度的重复测量显示，变异性AP患者在一天中任何采样点的值均高于对照者。变异性AP组夜间CV明显更高。硫酸阿托品（口服1.5mg/天）可消除这种升高的CV。毛果芸香碱注射（皮下注射1.3mg/10kg体重）使5例变异性AP患者的CV显著增加，且在胸痛和/或缺血性ECG改变出现之前。毛果芸香碱给药后10分钟时，变异性AP患者的CV增量大于对照者（p<0.05）。结论是，增强的副交感神经活动可能在与交感神经功能亢进相关的冠状动脉痉挛发作中起作用。
