Araki H, Anan T, Koiwaya Y, Nakagaki O, Takeshita A, Nakamura M
Am Heart J. 1984 Nov;108(5):1273-8. doi: 10.1016/0002-8703(84)90753-1.
Responses of heart rate and blood pressure to transient myocardial ischemia were analyzed in patients with variant angina. Heart rate changes during ST segment elevation were examined by means of a Holter ECG monitoring system. All 27 ST segment elevations from 10 patients with anterior ischemia were accompanied by an increase in heart rate by 12 +/- 2 bpm (mean +/- SEM, p less than 0.001) at peak ST segment elevation. With inferior ischemia in nine patients, heart rate decreased significantly by 4 +/- 1 bpm (n = 28, p less than 0.001). However, 9 of these 28 ST segment elevations showed a biphasic response of heart rate, that is, an initial increase and subsequent decrease. Such heart rate changes were not different between ST segment elevations with and without chest pain. With chest pain systolic blood pressure rose in anterior ischemia by 42 +/- 5 mm Hg (n = 10, p less than 0.001) but fell in inferior ischemia by 22 +/- 8 mm Hg (n = 7, p less than 0.05). We conclude that a different cardiovascular reflex occurs in response to inferior versus anterior ischemia and it is independent of chest pain.
分析了变异型心绞痛患者心率和血压对短暂性心肌缺血的反应。通过动态心电图监测系统检查ST段抬高期间的心率变化。10例前壁缺血患者的所有27次ST段抬高在ST段抬高峰值时均伴有心率增加12±2次/分（平均值±标准误，p<0.001）。9例下壁缺血患者，心率显著下降4±1次/分（n=28，p<0.001）。然而，这28次ST段抬高中有9次显示心率呈双相反应，即最初增加随后下降。有胸痛和无胸痛的ST段抬高之间的心率变化无差异。在前壁缺血时，胸痛时收缩压升高42±5mmHg（n=10，p<0.001），而下壁缺血时收缩压下降22±8mmHg（n=7，p<0.05）。我们得出结论，下壁缺血与前壁缺血相比会发生不同的心血管反射，且与胸痛无关。
