Jordan J, Yamaguchi I, Mandel W J
Circulation. 1977 Apr;55(4):569-74. doi: 10.1161/01.cir.55.4.569.
Electrophysiologic studies were performed in 32 patients with angiographically documented coronary artery disease (CAD). Group I was composed of ten patients (31%) with severe stenosis (greater than or equal to 75%) proximal to the origin of the sinus node artery (SNA); group II was composed of five patients (16%) with moderate (50--75%) proximal stenosis; and group III was composed of 17 patients (53%) with insignificant (0--50%) proximal stenosis. The mean sinoatrial conduction time (SACT) for group I was 119 +/- 18 msec; group II was 84+/- 16 msec; and group III was 72 +/- 5 msec. The SACT was significantly longer in group I than in group III (P less than 0.005). In conclusion 1) in patients with CAD, SACT greater than 72 +/- 5 msec is abnormal; 2) the results suggest a pathogenetic role of CAD in the development of sinus node dysfunction; 3) the SACT is a more sensitive indicator of subtle sinus node dysfunction in CAD patients than is heart rate, sinus node response to artrial extrastimuli, or sinus node recovery time; and 4) the ability to diagnose sinus node dysfunction in its early stages and recognition that coronary artery disease is an etiologic factor may allow for the elucidation of the natural history of the sick sinus syndrome.
对32例经血管造影证实患有冠状动脉疾病（CAD）的患者进行了电生理研究。第一组由10例（31%）患者组成，其窦房结动脉（SNA）起源近端存在严重狭窄（大于或等于75%）；第二组由5例（16%）患者组成，其近端存在中度狭窄（50%-75%）；第三组由17例（53%）患者组成，其近端狭窄不明显（0%-50%）。第一组的平均窦房传导时间（SACT）为119±18毫秒；第二组为84±16毫秒；第三组为72±5毫秒。第一组的SACT明显长于第三组（P<0.005）。总之，1）在CAD患者中，SACT大于72±5毫秒即为异常；2）结果提示CAD在窦房结功能障碍的发生中起致病作用；3）在CAD患者中，SACT是比心率、窦房结对房性期外刺激的反应或窦房结恢复时间更敏感的细微窦房结功能障碍指标；4）早期诊断窦房结功能障碍的能力以及认识到冠状动脉疾病是病因之一，可能有助于阐明病态窦房结综合征的自然病史。
