Yasue H, Kugiyama K
Division of Cardiology, Kumamoto University School of Medicine.
Intern Med. 1997 Nov;36(11):760-5. doi: 10.2169/internalmedicine.36.760.
Coronary artery spasm (coronary spasm) is an abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia and its incidence is relatively high in Japanese as compared with Caucasians. Coronary spasm occurs most often from midnight to early morning when the patient is at rest and it is usually not induced by exercise in the daytime. Coronary spasm can be induced by acetylcholine, an endothelium-dependent vasodilator which causes vasodilatation in the normal coronary artery. Spasm artery is hyperresponsive to the vasodilator effect of nitroglycerin, an nitric oxide (NO) donor and is deficient in NO activity. The major risk factor for coronary spasm is cigarette smoking. Coronary spasm can be a cause of not only variant angina but also ischemic heart disease in general, including unstable angina, acute myocardial infarction and sudden ischemic death.
冠状动脉痉挛是心外膜冠状动脉的异常收缩，导致心肌缺血，与白种人相比，其在日本人中的发病率相对较高。冠状动脉痉挛最常发生在午夜至清晨患者休息时，通常不会由白天的运动诱发。乙酰胆碱这种内皮依赖性血管扩张剂可诱发冠状动脉痉挛，它在正常冠状动脉中会引起血管扩张。痉挛动脉对一氧化氮（NO）供体硝酸甘油的血管扩张作用反应过度，且NO活性不足。冠状动脉痉挛的主要危险因素是吸烟。冠状动脉痉挛不仅可以是变异型心绞痛的病因，也是一般缺血性心脏病的病因，包括不稳定型心绞痛、急性心肌梗死和突发性缺血性死亡。
