Williams D O, Riley R S, Singh A K, Most A S
J Am Coll Cardiol. 1983 May;1(5):1268-72. doi: 10.1016/s0735-1097(83)80139-9.
The hypothesis that successful percutaneous transluminal coronary angioplasty restores normal coronary circulatory dynamics was tested. Regional coronary blood flow, myocardial oxygen consumption and lactate extraction were measured at rest and during sustained pacing tachycardia. Before angioplasty, tachycardia stress was associated with an attenuated blood flow and oxygen consumption response and the induction of anaerobic metabolism. After successful angioplasty, blood flow and myocardial oxygen consumption increased during tachycardia stress and aerobic metabolism was sustained. The influence of basal alpha-adrenergic tone in modifying the time course of blood flow response to abrupt pacing was also assessed. Patients with normal coronary arteries demonstrated delayed increase in blood flow after alpha-adrenergic blockade. Alpha-adrenergic blockade did not affect the time course of blood flow response in patients with coronary artery disease, suggesting that alpha-adrenergic tone was chronically withdrawn. In patients undergoing coronary angioplasty, flow response before angioplasty was delayed, consistent with withdrawal of basal alpha-adrenergic tone. After coronary angioplasty, a brisk flow response was observed, indicating that basal alpha-adrenergic tone had been restored. Thus, successful coronary angioplasty restores the normal responsiveness of the coronary circulation.
对成功的经皮腔内冠状动脉成形术可恢复正常冠状动脉循环动力学这一假说进行了验证。在静息状态和持续性起搏性心动过速期间测量了局部冠状动脉血流量、心肌耗氧量和乳酸摄取量。在血管成形术前，心动过速应激与血流量和耗氧量反应减弱以及无氧代谢的诱导有关。成功的血管成形术后，心动过速应激期间血流量和心肌耗氧量增加，有氧代谢得以维持。还评估了基础α-肾上腺素能张力对突然起搏时血流量反应时间进程的影响。冠状动脉正常的患者在α-肾上腺素能阻断后血流量增加延迟。α-肾上腺素能阻断对冠状动脉疾病患者的血流量反应时间进程没有影响，表明α-肾上腺素能张力长期减退。在接受冠状动脉成形术的患者中，血管成形术前的血流反应延迟，这与基础α-肾上腺素能张力减退一致。冠状动脉成形术后，观察到血流反应活跃，表明基础α-肾上腺素能张力已恢复。因此，成功的冠状动脉成形术可恢复冠状动脉循环的正常反应性。
