Perez-Gomez F, Martin de Dios R, Rey J, Garcia Aguado A
Br Heart J. 1979 Jul;42(1):81-7. doi: 10.1136/hrt.42.1.81.
Previous angiographic studies have shown that coronary spasm occurs in association with the variant angina described by Prinzmetal, confirming his original hypothesis. In this work we recorded the heart rate changes and the incidence of arrhythmias during variant angina. The patients were divided into two groups: anterior, with electrocardiographic signs of anterior ischaemia, and inferior, with changes in the inferior leads. There was a significant increase of heart rate during pain in anterior myocardial ischaemia and a significant decrease when the ischaemia was inferior. The incidence of ectopic arrhythmias during pain was significantly greater in patients with anterior ischaemia, but there was a high incidence of atrioventricular block in patients with inferior ischaemia. We suggest that these findings can be explained by different responses of the automatic nervous system to anterior and inferior acute myocardial ischaemia.
以往的血管造影研究表明，冠状动脉痉挛与普林兹梅尔描述的变异型心绞痛相关，证实了他最初的假设。在这项研究中，我们记录了变异型心绞痛发作时的心率变化和心律失常的发生率。患者被分为两组：前壁组，有前壁缺血的心电图表现；下壁组，下壁导联有变化。前壁心肌缺血疼痛发作时心率显著增加，而下壁缺血时心率显著降低。前壁缺血患者疼痛发作时异位心律失常的发生率显著更高，但下壁缺血患者房室传导阻滞的发生率较高。我们认为，这些发现可以通过自主神经系统对前壁和下壁急性心肌缺血的不同反应来解释。
