Goldberg S, Reichek N, Wilson J, Hirshfeld J W, Muller J, Kastor J A
Am J Cardiol. 1979 Oct 22;44(5):804-10. doi: 10.1016/0002-9149(79)90201-7.
The clinical response to therapy with the calcium-blocking agent nifedipine was assessed in 12 patients with variant angina pectoris who were 44 to 67 years old. Five patients had vasospasm of the left anterior descending coronary artery, and seven had spasm of a dominant right coronary artery. Before nifedipine therapy, the frequency of anginal attacks per 24 hour period ranged from 1 to 12, with ventricular tachycardia accompanying ischemic episodes in 7 of 12 patients and high grade atrioventricular block occurring in 2 patients. After therapy with nifedipine, 11 of 12 patients had initial relief of symptoms, and 7 of the 11 had long-term relief. Withdrawal of nifedipine led to recurrence of angina on six occasions in four patients. Provocative testing in the cardiac catheterization laboratory by means of the cold pressor test in one patient and ergonovine maleate in another before and after nifedipine administration showed that this agent can block both alpha adrenergic- and regonovine-induced vasospasm. Nifedipine may have a significant role in the therapy of angina caused by coronary spasm.
对12例年龄在44至67岁之间的变异型心绞痛患者使用钙阻滞剂硝苯地平进行治疗的临床反应进行了评估。5例患者出现左前降支冠状动脉痉挛，7例患者出现优势右冠状动脉痉挛。在硝苯地平治疗前，每24小时心绞痛发作频率为1至12次，12例患者中有7例在缺血发作时伴有室性心动过速，2例患者出现高度房室传导阻滞。使用硝苯地平治疗后，12例患者中有11例症状最初得到缓解，11例中有7例长期缓解。4例患者停用硝苯地平后有6次出现心绞痛复发。在一名患者中通过冷加压试验、在另一名患者中在硝苯地平给药前后通过马来酸麦角新碱在心脏导管实验室进行激发试验，结果表明该药物可阻断α肾上腺素能和麦角新碱诱导的血管痉挛。硝苯地平在冠状动脉痉挛所致心绞痛的治疗中可能具有重要作用。
