Byun T, Uchida T, Haruta S, Shinoda N, Kato J, Sugiura R, Aoka Y, Mori F, Oomori H, Kodama S, Kasahara S, Hirosawa K, Hosoda S
Sendai Cardiovascular Center.
J Cardiol. 1996 Aug;28(2):61-9.
The relationship between coronary vasospasticity and the development of atherosclerotic lesion was studied in 24 patients with vasospastic angina. All patients had no organic stenosis initially and underwent follow-up coronary angiography at 66 +/- 9 months after the initial examination. The coronary artery diameter was measured with the contour detection method. The spastic and non-spastic sites were identified at the initial coronary angiography with the acetylcholine provocation test. The change of the luminal diameter (delta LD) and the ratio of the change of luminal diameter (% delta LD) were compared at the spastic and the non-spastic sites. The follow-up examination showed significant decreases of coronary artery diameter in both the spastic (2.35 +/- 0.67 vs 2.16 +/- 0.58 mm, p < 0.001) and non-spastic sites (2.66 +/- 0.91 vs 2.54 +/- 0.84 mm, p = 0.02). However, delta LD and % delta LD were not different between the spastic and non-spastic sites (delta LD: -0.19 +/- 0.40 vs -0.12 +/- 0.46 mm, NS; % delta LD: -6.7 +/- 14.8% vs -3.2 +/- 17.0%, NS). In conclusion, coronary vasospasticity does not promote the development of atherosclerotic lesion.
在24例血管痉挛性心绞痛患者中研究了冠状动脉痉挛与动脉粥样硬化病变发展之间的关系。所有患者最初均无器质性狭窄,并在初次检查后66±9个月接受了随访冠状动脉造影。采用轮廓检测法测量冠状动脉直径。通过乙酰胆碱激发试验在初次冠状动脉造影时确定痉挛部位和非痉挛部位。比较痉挛部位和非痉挛部位的管腔直径变化(ΔLD)和管腔直径变化率(%ΔLD)。随访检查显示,痉挛部位(2.35±0.67 vs 2.16±0.58 mm,p<0.001)和非痉挛部位(2.66±0.91 vs 2.54±0.84 mm,p = 0.02)的冠状动脉直径均显著减小。然而,痉挛部位和非痉挛部位之间的ΔLD和%ΔLD并无差异(ΔLD:-0.19±0.40 vs -0.12±0.46 mm,无显著性差异;%ΔLD:-6.7±14.8% vs -3.2±17.0%,无显著性差异)。总之,冠状动脉痉挛不会促进动脉粥样硬化病变的发展。