Matsuda Y, Ogawa H, Moritani K, Fujii T, Yoshino F, Katayama K, Miura T, Toma Y, Matsuda M, Kusukawa R
Am Heart J. 1984 Oct;108(4 Pt 1):959-66. doi: 10.1016/0002-8703(84)90461-7.
Coronary angiography was performed at rest and during bicycle exercise immediately after the onset of angina and significant ST segment elevation or depression in the ECG. Of 11 patients, six showed significant reduction of coronary lumen diameter at the site of organic stenosis; mean values of stenosis (range) before and during exercise were 55% (25% to 88%) and 98% (89% to 100%), respectively. Five patients did not have any diameter change of the organic lesion; mean values of stenosis (range) before and during exercise were 84% (74% to 89%) and 84% (73% to 92%), respectively. Excluding the areas of these stenoses, diameters of left main coronary artery, proximal, middle, and distal left anterior descending, circumflex, and right coronary artery segments were measured before and during exercise. Diameter in each coronary artery segment during exercise was not significantly changed from that before exercise, both in the groups with and without diameter reduction. Exercise provoked a localized worsening of coronary artery stenosis without changing the diameter in the remaining artery. These findings suggest that the worsening of stenosis might be caused by a regional abnormality of the coronary artery that is not necessarily related to the degree of organic stenosis.
在心绞痛发作以及心电图出现明显ST段抬高或压低后，立即进行静息状态下和自行车运动期间的冠状动脉造影。11例患者中，6例在器质性狭窄部位显示冠状动脉管腔直径明显减小；运动前和运动期间狭窄的平均值（范围）分别为55%（25%至88%）和98%（89%至100%）。5例患者的器质性病变部位管腔直径无变化；运动前和运动期间狭窄的平均值（范围）分别为84%（74%至89%）和84%（73%至92%）。排除这些狭窄区域后，测量运动前和运动期间左冠状动脉主干、左前降支近端、中段和远端、回旋支以及右冠状动脉节段的直径。在有和没有管腔直径减小的两组中，各冠状动脉节段运动期间的直径与运动前相比均无明显变化。运动引发冠状动脉狭窄局部加重，而其余动脉直径未改变。这些发现表明，狭窄加重可能是由冠状动脉的局部异常引起的，不一定与器质性狭窄程度相关。
