Parmley W W
Angiology. 1977 Dec;28(12):865-72. doi: 10.1177/000331977702801207.
The pathophysiology of angina pectoris is best understood as an imbalance between oxygen supply and demand. The primary determinants of myocardial oxygen demand are heart rate, arterial pressure, heart size, myocardial contractility, and myocardial mass. The medical therapy of angina pectoris is directed toward reducing myocardial oxygen demand by reducing the workload of the heart and the specific determinants listed. The most common medications used in the treatment of angina pectoris are nitroglycerin and propranolol. Nitroglycerin reduces myocardial oxygen demand primarily by reducing heart size and arterial pressure. Propranolol reduces oxygen demand primarily by reducing heart rate. Medical therapy is generally effective in controlling the symptoms of angina pectoris in 80% or more of the patients and allows them to lead useful and productive lives.
心绞痛的病理生理学最好理解为氧供与需求之间的失衡。心肌需氧量的主要决定因素是心率、动脉压、心脏大小、心肌收缩力和心肌质量。心绞痛的药物治疗旨在通过减轻心脏工作量以及上述特定决定因素来降低心肌需氧量。治疗心绞痛最常用的药物是硝酸甘油和普萘洛尔。硝酸甘油主要通过减小心脏大小和降低动脉压来降低心肌需氧量。普萘洛尔主要通过降低心率来降低需氧量。药物治疗通常能有效控制80%或更多患者的心绞痛症状，使他们能够过上有益且充实的生活。
