Glatzel H
Z Psychosom Med Psychoanal. 1987;33(3):252-65.
After decades of morphological, biochemical, experimental, epidemiological and clinical studies it is still not possible to throw light on the pathogenesis of coronary disease, in particular on that of the heart attack. The classical explanation for the clinical picture of heart attack and its main symptom, angina pectoris, as a clinical expression of the morphological illness of coronary sclerosis has proved to be erroneous: There are severe cases of coronary sclerosis with occlusion but no clinical symptom of heart attack, and there are severe coronary infarctions with no arteriosclerotic coronary occlusion. Several years of experimental, epidemiological and clinical study have shown that a diet rich in saturated fats and cholesterol is pathogenetically irrelevant. The solution to the question of the pathogenesis of heart attack lies in the area of psychosomatics.
经过数十年的形态学、生物化学、实验、流行病学和临床研究，仍无法阐明冠心病的发病机制，尤其是心脏病发作的发病机制。对于心脏病发作的临床表现及其主要症状心绞痛，作为冠状动脉硬化形态学疾病的临床表征，传统解释已被证明是错误的：存在冠状动脉硬化严重且堵塞但无心脏病发作临床症状的情况，也存在严重冠状动脉梗死但无动脉粥样硬化性冠状动脉堵塞的情况。数年的实验、流行病学和临床研究表明，富含饱和脂肪和胆固醇的饮食在发病机制上并无关联。心脏病发作发病机制问题的答案在于身心医学领域。
