Dumesnil J G, Ritman E L, Davis G D, Gau G T, Rutherford B D, Frye R L
Am J Cardiol. 1975 Oct 6;36(4):419-25. doi: 10.1016/0002-9149(75)90888-7.
Regional wall dynamics of the left ventricle before and after sublingual administration of 0.6 mg of nitroglycerin were determined from left ventricular angiograms in 27 patients undergoing coronary arteriography. Regional wall dynamics were quantitatively measured from 60/sec determinations of wall thickness and derived peak rate of systolic wall thickening (peak dTw/dt) in selected sites of the left ventricle. A total of 70 regions were studied. Analysis of the same segment before and after administration of nitroglycerin revealed that the mean change in peak dTw/dt was +1.97 cm/sec in segments with an initial peak dTw/dt of less than 5 cm/sec, in contrast to a change of +0.66 cm/sec in segments with an initial control value of 5 cm/sec or greater. Akinetic or dyskinetic areas did not show improvements after nitroglycerin. In 11 left ventriculograms, an area that was initially hypokinetic manifested an increase in rate of wall thickening after nitroglycerin. The mean increase in peak dTw/dt in anterior segments with electrocardiographic evidence of myocardial infarction was 0.18 cm/sec (P less than 0.05) after nitroglycerin, compared with a mean change of 1.33 cm/sec in anterior segments without such evidence. This study presents evidence for a regional myocardial response to nitroglycerin with differing responses within the same ventricle apparently depending upon the functional state of the underlying myocardium.
对27例接受冠状动脉造影的患者，通过左心室血管造影测定舌下含服0.6毫克硝酸甘油前后左心室的局部壁动力学。通过每秒60次测定左心室选定部位的壁厚和推算的收缩期壁增厚峰值速率（峰值dTw/dt）来定量测量局部壁动力学。共研究了70个区域。硝酸甘油给药前后对同一节段的分析显示，初始峰值dTw/dt小于5厘米/秒的节段，峰值dTw/dt的平均变化为+1.97厘米/秒，而初始对照值为5厘米/秒或更高的节段，变化为+0.66厘米/秒。无运动或运动障碍区域在硝酸甘油给药后未显示改善。在11份左心室造影中，一个最初运动减弱的区域在硝酸甘油给药后壁增厚速率增加。有心肌梗死心电图证据的前壁节段，硝酸甘油给药后峰值dTw/dt的平均增加为0.18厘米/秒（P小于0.05），而无此类证据的前壁节段平均变化为1.33厘米/秒。本研究提供了证据，表明同一心室内硝酸甘油引起的局部心肌反应不同，这显然取决于潜在心肌的功能状态。
