Repeated epicardial coronary artery endothelial injuries lead to a global spontaneous coronary artery spasm
Repeated epicardial coronary artery endothelial injuries lead to a global spontaneous coronary artery spasm
复制标题
DOI：
10.1097/00019501-200405000-00002
复制
发表时间：
2004-05-01
影响因子：
1.8
通讯作者：
Maruyama, Y
中科院分区：
文献类型：
--
作者：
Saitoh, S;Muto, M;Maruyama, Y
目的本研究旨在建立自发性冠状动脉痉挛模型。材料和方法对12头猪进行心外膜左冠状动脉前降支(LAD)球囊内皮剥脱术，每2周一次，共4次。每次剥脱前和第 8 周评估乙酰胆碱或血清素引起的剥脱部位直径和 LAD 血流量的变化。在清醒和不受约束的猪中连续监测 LAD 区域的血压、心电图 (ECG) 和 LAD 血流量。结果 自发性心电图 ST 压低伴 LAD 血流量减少在 2 周左右出现。据此，0.5 杯/千克乙酰胆碱诱导了类似的心电图和 LAD 血流变化，而没有裸露部位变窄，这表明微血管痉挛。此后，6周后发现心电图ST通过裸露部位痉挛而降低或升高，并观察到心外膜冠状动脉痉挛导致的自发性心电图ST变化。结论心外膜冠状动脉内皮损伤可能引起下游冠状微血管以及裸露部分的自发血管痉挛，提示整个冠状动脉树的功能异常。
Objectives This study was conducted to develop a spontaneous coronary spasm model.Materials and methods Balloon endothelial denudation was carried out in the epicardial left anterior descending coronary artery (LAD) every 2 weeks, for a total of four times, in 12 pigs. Changes in the denuded site diameter and LAD blood flow caused by acetylcholine or serotonin were assessed before each denudation and at week 8. Blood pressure, electrocardiogram (ECG) from the LAD area and LAD blood flow were monitored continuously in conscious and unrestrained pigs.Results Spontaneous ECG ST depression with a decrease in LAD blood flow appeared at around 2 weeks. In accordance with this, 0.5 mug/kg acetylcholine induced similar ECG and LAD blood flow changes without denuded site narrowing, suggesting microvascular spasm. Thereafter, ECG ST depression or elevation by serotonin via a denuded site spasm was found after 6 weeks and spontaneous ECG ST changes due to epicardial coronary artery spasm were observed.Conclusion Epicardial coronary artery endothelial injury may induce spontaneous vasospasticity in the downstream coronary microvessels as well as in the denuded portion, suggesting functional abnormality through the entire coronary arterial tree.