Schwartz L, Sole M J, Vaughan-Neil E F, Hussain N M
Circulation. 1979 Jan;59(1):37-43. doi: 10.1161/01.cir.59.1.37.
We measured aortic and coronary sinus dopamine (DA), epinephrine (E), and norepinephrine (NE) in eight patients with cardiac ischemia (I) and eight control subjects (C). Samples were taken at rest (73 +/- 3 beats/min in C and 68 +/- 3 beats/min in I) and during coronary sinus pacing to peak rates (144 +/- 4 beats/min in C and 136 +/- 6 beats/min in I). Arterial NE was higher in the ischemic patients at rest (254 +/- 25 pg/ml in C and 324 +/- 21 in I; p less than 0.05). There were no differences in arterial E and DA. Neither pacing nor angina affected peripheral catecholamine concentrations. Resting myocardial NE flux was similar for both groups. With pacing, coronary sinus flow and net myocardial NE release increased significantly in both groups. The maximum relative increase in net myocardial NE release was less in the ischemic patients than in the controls (575 +/- 145% in C and 255 +/- 40% in I; p less than 0.05). Thus, angina induced by pacing does not augment peripheral sympathetic activity. Furthermore, pacing-induced angina appears to be associated with a decrease in cardiac sympathetic tone compared with that found in paced controls.
我们测量了8例心肌缺血患者（I组）和8例对照者（C组）的主动脉和冠状窦中的多巴胺（DA）、肾上腺素（E）和去甲肾上腺素（NE）。在静息状态下（C组心率为73±3次/分钟，I组为68±3次/分钟）以及冠状窦起搏至心率峰值时（C组为144±4次/分钟，I组为136±6次/分钟）采集样本。静息时，缺血患者的动脉NE水平较高（C组为254±25 pg/ml，I组为324±21 pg/ml；p<0.05）。动脉E和DA水平无差异。起搏和心绞痛均未影响外周儿茶酚胺浓度。两组静息时的心肌NE通量相似。起搏时，两组的冠状窦血流量和心肌NE净释放量均显著增加。缺血患者心肌NE净释放量的最大相对增加幅度低于对照组（C组为575±145%，I组为255±40%；p<0.05）。因此，起搏诱发的心绞痛不会增强外周交感神经活动。此外，与起搏对照组相比，起搏诱发的心绞痛似乎与心脏交感神经张力降低有关。
