de Servi S, Ardissino D, Mussini A, Angoli L, Bramucci E, Falcone C, Specchia G
Jpn Heart J. 1985 Nov;26(6):1029-37. doi: 10.1536/ihj.26.1029.
Regional myocardial blood flow during exercise was determined using the thermodilution technique in 2 patients suffering from both spontaneous and exertional chest pain. In both cases we observed that effort-related anginal attacks were due to coronary spasm with sudden reduction of regional left ventricular blood flow. In 1 patient the exercise-induced ST-segment elevation in the anterior leads was accompanied by a reduction of flow in the great cardiac vein. In the second patient the exercise-induced ST-segment depression in the lateral leads was accompanied by a reduction of coronary flow in the area supplied by the circumflex artery. In 1 patient, nifedipine was effective in prolonging exercise tolerance by preventing the occurrence of coronary spasm and by increasing blood supply to the ischemic region during exercise.
采用热稀释技术测定了2例既有自发性胸痛又有劳力性胸痛患者运动期间的局部心肌血流量。在这两例患者中，我们均观察到与运动相关的心绞痛发作是由于冠状动脉痉挛，导致局部左心室血流量突然减少。在1例患者中，前壁导联运动诱发的ST段抬高伴有大冠状动脉血流量减少。在第2例患者中，侧壁导联运动诱发的ST段压低伴有回旋支动脉供血区域冠状动脉血流量减少。在1例患者中，硝苯地平通过预防冠状动脉痉挛的发生以及在运动期间增加对缺血区域的血液供应，有效延长了运动耐量。
