Byun T, Uchida T, Hirosawa K, Mori F, Oomori H, Nagashima M, Enta K, Kodama S, Kasahara S, Iwade K, Hosoda S
Sendai Cardiovascular Center.
J Cardiol. 1997 May;29(5):243-50.
The reproducibility of coronary vasospasm was assessed in nine patients with complete remission of vasospastic angina by medical treatment by reexamination at intervals of mean [+/-SD] 5.7 +/- 0.9 years. Twenty-one segments were defined as spastic, demonstrating more than 90% narrowing after acetylcholine injection at the initial angiography. The degree of spasticity, type of spasm (diffuse or focal) and coronary artery diameter in these segments at the initial and follow-up studies were compared. Of the 21 segments, 17 (81%) still had some spasticity (> 25%) at the follow-up study and 8 (38%) of these 17 showed spasticity with greater than 90% narrowing. On the other hand, spasm was not reprovoked in 4 (19%) segments. Luminal diameter of the spastic segments decreased significantly at the follow-up study (2.52 +/- 0.83 vs 2.26 +/- 0.62 mm, p = 0.01), but percentage stenosis was not different between the initial and follow-up studies (9.1 +/- 7.2 vs 10.3 +/- 8.0%, NS). The reproducibility of the type of spasm provoked was 83%. Coronary vasospasticity persists to some extent in spite of complete remission of angina by medical treatment, and the type of spasm provoked has high reproducibility. Therefore, the cessation of drug treatment should be done carefully.
通过药物治疗，对9例血管痉挛性心绞痛完全缓解的患者进行了冠状动脉痉挛再现性的评估，复查间隔时间平均为[+/-标准差]5.7±0.9年。21个节段被定义为痉挛性节段，在初始血管造影时注射乙酰胆碱后显示狭窄超过90%。比较了这些节段在初始和随访研究时的痉挛程度、痉挛类型（弥漫性或局灶性）以及冠状动脉直径。在这21个节段中，17个（81%）在随访研究时仍有一定程度的痉挛（>25%），其中8个（38%）显示痉挛时狭窄超过90%。另一方面，4个（19%）节段未再次诱发痉挛。随访研究时痉挛节段的管腔直径显著减小（2.52±0.83 vs 2.26±0.62 mm，p = 0.01），但初始和随访研究时的狭窄百分比无差异（9.1±7.2 vs 10.3±8.0%，无显著性差异）。诱发的痉挛类型的再现性为83%。尽管药物治疗使心绞痛完全缓解，但冠状动脉痉挛在一定程度上仍然存在，且诱发的痉挛类型具有较高的再现性。因此，应谨慎停用药物治疗。
