变异型心绞痛患者在自发及运动诱发ST段抬高时的冠状动脉造影和左心室造影。

Coronary arteriography and left ventriculography during spontaneous and exercise-induced ST segment elevation in patients with variant angina.

作者信息

Matsuda Y, Ozaki M, Ogawa H, Naito H, Yoshino F, Katayama K, Fujii T, Matsuzaki M, Kusukawa R

出版信息

Am Heart J. 1983 Sep;106(3):509-15. doi: 10.1016/0002-8703(83)90694-4.

Abstract

The present study is an angiographic demonstration of coronary artery spasm during both spontaneous and exercise-induced angina in three patients with variant angina. In each case, clinical, ECG, coronary angiographic, and left ventriculographic observations were made at rest, during spontaneous angina, and during exercise-induced angina. The character of chest pain was similar during spontaneous and exercise-induced episodes. ST segment elevation was present in the anterior ECG leads during both episodes. The left anterior descending coronary artery became partially or totally obstructed during both types of attacks. When coronary spasm was demonstrated during both types of attacks, left ventriculography disclosed akinetic or dyskinetic wall motion in the area supplied by the involved artery. In those patients with reproducible exercise-induced ST segment elevation and chest pain, thallium-201 scintigraphy showed areas of reversible anteroseptal hypoperfusion. Thus in selected patients exercise-induced attacks of angina were similar to spontaneous episodes.

摘要

本研究是对3例变异型心绞痛患者在自发性和运动诱发心绞痛发作时冠状动脉痉挛的血管造影显示。在每个病例中，均在静息状态、自发性心绞痛发作时和运动诱发心绞痛发作时进行了临床、心电图、冠状动脉造影和左心室造影观察。自发性发作和运动诱发发作时胸痛的特点相似。两种发作时心电图前壁导联均出现ST段抬高。在两种类型的发作中，左前降支冠状动脉均出现部分或完全阻塞。当在两种类型的发作中均证实有冠状动脉痉挛时，左心室造影显示受累动脉供血区域的室壁运动减弱或运动障碍。在那些运动诱发的ST段抬高和胸痛可重复出现的患者中，铊-201闪烁扫描显示前间隔可逆性灌注减低区域。因此，在选定的患者中，运动诱发的心绞痛发作与自发性发作相似。