Dagenais G R, Jalbert B
Circulation. 1977 Aug;56(2):315-9. doi: 10.1161/01.cir.56.2.315.
To evaluate whether elevated arterial free fatty acids (FFA) increase myocardial oxygen demand and ischemia, 15 fasting patients with coronary artery disease underwent a standardized atrial pacing test before (PTI) and during (PT2) heparin infusion. The patients were monitored for clinical and electrocardiographic (ECG) manifestations of ischemia. Myocardial extraction of lactate, inorganic phosphate, oxygen and FFA was measured before and during each PT. The control arterial FFA was 0.65 +/- 0.03 micromole/ml and rose to 1.83 +/- 0.16 micromole/ml during heparin influsion. Myocardial oxygen extraction at rest and during PT was not affected by the increase in arterial FFA. Seven patients asymptomatic during PT1 did not develop ischaemic manifestations during PT2. In eight patients with angina during both PTs, increased arterial FFA concentration did not modify the severity of anginal pain, the amount of ST-segment depression and the myocardial balance of lactate or inorganic phosphate. Elevation of arterial FFA by heparin neither increased myocardial oxygen extraction at rest or during pacing nor accentuated ischemic manifestations during PT.
为评估动脉血游离脂肪酸（FFA）升高是否会增加心肌需氧量和导致心肌缺血，15例空腹冠心病患者在肝素输注前（PTI）和输注期间（PT2）接受了标准化心房起搏试验。对患者进行缺血的临床和心电图（ECG）表现监测。在每次PT前后测量心肌对乳酸、无机磷酸盐、氧气和FFA的摄取。对照动脉血FFA为0.65±0.03微摩尔/毫升，在肝素输注期间升至1.83±0.16微摩尔/毫升。静息时和PT期间的心肌氧摄取不受动脉血FFA升高的影响。7例在PT1期间无症状的患者在PT2期间未出现缺血表现。在两次PT期间均有心绞痛的8例患者中，动脉血FFA浓度升高并未改变心绞痛疼痛的严重程度、ST段压低的程度以及心肌乳酸或无机磷酸盐的平衡。肝素引起的动脉血FFA升高既未增加静息时或起搏期间的心肌氧摄取，也未加重PT期间的缺血表现。
