Orlock A E, Ricci D R, Cipriano P R, Guthaner D F, Harrison D C
Am J Cardiol. 1980 Jan;45(1):48-52. doi: 10.1016/0002-9149(80)90218-0.
The coronary hemodynamic effects of ergonovine maleate were examined in 15 patients with a chest pain syndrome not thought to be variant angina. Ergonovine was given intravenously in sequential doses of 0.05, 0.1 and 0.25 mg while measurements were made of systemic hemodynamic variables, coronary sinus blood flow and coronary arteriovenous oxygen difference at intervals during the protocol. Coronary arterial diameters were measured from the 35 mm cineangiogram. Despite an increase in myocardial metabolic demand, as estimated with the heart-rate-blood pressure product, there was no apparent increase in coronary vascular resistance. In addition, there was a significant widening of the coronary arteriovenous oxygen difference in five of the seven patients in whom it could be measured. However, neither chest pain nor ischemic electrocardiographic changes were evoked. Although ergonovine also produced a diminution in epicardial coronary arterial diameters, this effect was not sufficient to explain the absence of appropriate coronary vasodilation. These results suggest that ergonovine may limit the normal vasodilatory response of the arteriolar bed to increases in myocardial metabolic demand.
对15例被认为不是变异型心绞痛的胸痛综合征患者进行了马来酸麦角新碱的冠状动脉血流动力学效应研究。静脉内依次给予0.05、0.1和0.25mg的麦角新碱，同时在方案实施过程中间隔测量全身血流动力学变量、冠状窦血流量和冠状动脉动静脉血氧差。从35mm电影血管造影片测量冠状动脉直径。尽管根据心率-血压乘积估计心肌代谢需求增加，但冠状动脉血管阻力没有明显增加。此外，在7例可测量的患者中，有5例冠状动脉动静脉血氧差显著增宽。然而，既未诱发胸痛，也未出现缺血性心电图改变。虽然麦角新碱也使心外膜冠状动脉直径缩小，但这种作用不足以解释未出现适当的冠状动脉血管舒张。这些结果提示，麦角新碱可能会限制小动脉床对心肌代谢需求增加的正常血管舒张反应。
