Ishikawa K, Hayashi T, Otani S, Kanamasa K, Yamakado T, Osato S, Tashi M, Kohashi Y, Katori R
J Cardiogr. 1981 Jun;11(2):425-30.
Left ventricular size at different portions was evaluated following the administration of nitroglycerin to find whether there is any regional difference in the amount of shortening. In 6 patients with old myocardial infarction, biplane coronary cineangiograms were obtained before and after sublingual administration of nitroglycerin of 0.3 mg. The coordinates of the bifurcations of the left coronary artery at multiple sites were measured on the postero-anterior and lateral films and the spatial lengths (L) between any paired two points were calculated frame by frame covering one cardiac cycle. The maximum length (Lmax) was 63.2 +/- 3.1 (SE) mm before nitroglycerin as a whole and was 61.4 +/- 2.9 mm after nitroglycerin, showing no significant change. The minimum length (Lmin) also showed no significant change after nitroglycerin; from 56.1 +/- 2.9 to 54.9 +/- 2.6 mm. However, at the free wall, Lmax after nitroglycerin was reduced by 4.5 +/- 2.5%, and Lmax at the anterior septum was also reduced by 3.0 +/- 1.3%. Lmax at the base was unchanged after nitroglycerin. Lmin at the free wall and at the anterior septum were also reduced after nitroglycerin, 4.4 +/- 2.6 and 2.9 +/- 1.2%, respectively, and it was unchanged at the base. Since a reduction in the left ventricular size is effective in reducing myocardial oxygen demand and is effective in treating myocardial ischemia, it was suggested that nitroglycerin is more effective in relieving ischemia at the free wall and septum and less effective at the base.
在给予硝酸甘油后,评估左心室不同部位的大小,以确定缩短量是否存在任何区域差异。对6例陈旧性心肌梗死患者,在舌下含服0.3mg硝酸甘油前后进行双平面冠状动脉造影。在正位和侧位片上测量左冠状动脉多个部位分支的坐标,并逐帧计算一个心动周期内任意两点之间的空间长度(L)。硝酸甘油给药前整体最大长度(Lmax)为63.2±3.1(标准误)mm,给药后为61.4±2.9mm,无显著变化。最小长度(Lmin)在硝酸甘油给药后也无显著变化,从56.1±2.9mm变为54.9±2.6mm。然而,在游离壁,硝酸甘油给药后Lmax降低了4.5±2.5%,前间隔的Lmax也降低了3.0±1.3%。基底部的Lmax在硝酸甘油给药后无变化。游离壁和前间隔的Lmin在硝酸甘油给药后也降低了,分别为4.4±2.6%和2.9±1.2%,基底部无变化。由于左心室大小的减小对降低心肌需氧量有效且对治疗心肌缺血有效,提示硝酸甘油在缓解游离壁和间隔的缺血方面更有效,而在基底部效果较差。