Horwitz L D, Gorlin R, Taylor W J, Kemp H G
J Clin Invest. 1971 Aug;50(8):1578-84. doi: 10.1172/JCI106645.
Regional myocardial blood flow before and after sublingual nitroglycerin was measured in 10 patients with coronary artery disease. During thoracotomy, (133)Xe was injected directly into the subepicardium in diseased regions of the anterior left ventricular wall, and washout rates were recorded with a scintillation counter. All disappearance curves were closely approximated by two exponential decays analyzed as two parallel flow systems by the compartmental method. The appearance of a double exponential decay pattern in diseased regions suggests that the slow phase was associated with collateral blood flow, although nonhomogeneous myocardium-to-blood partition coefficients for xenon cannot be excluded. Nitroglycerin increased the rapid phase flow in 9 of 10 patients and the slow flow in 7 of 10 patients. Average flow increased in 9 of the 10 patients (P < 0.01). Mean rapid phase flow in the control state was 110 ml/100 g per min and after nitroglycerin increased to 132 ml/100 g per min (P < 0.01); slow phase flow increased from 12 ml/100 g per min to 15 ml/100 g per min (P < 0.05). It is concluded that, under these conditions, nitroglycerin improves perfusion in regions of diseased myocardium in patients with coronary artery disease.
对10例冠心病患者舌下含服硝酸甘油前后的局部心肌血流量进行了测量。在开胸手术过程中，将（133）氙直接注入左心室前壁病变区域的心外膜下，并用闪烁计数器记录洗脱率。所有消失曲线都通过用房室法分析为两个平行流动系统的两个指数衰减来紧密拟合。病变区域出现双指数衰减模式表明，慢相与侧支血流有关，尽管不能排除氙的心肌与血液分配系数不均匀的情况。硝酸甘油使10例患者中的9例快速相血流增加，10例患者中的7例慢相血流增加。10例患者中有9例平均血流增加（P<0.01）。对照状态下的平均快速相血流为每分钟110ml/100g，硝酸甘油后增加至每分钟132ml/100g（P<0.01）；慢相血流从每分钟12ml/100g增加到每分钟15ml/100g（P<0.05）。得出的结论是，在这些条件下，硝酸甘油可改善冠心病患者病变心肌区域的灌注。
