Acute Effect of Intravenous Dipyridamole on Regional Coronary Hemodynamics and Metabolism
Acute Effect of Intravenous Dipyridamole on Regional Coronary Hemodynamics and Metabolism
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静脉注射双嘧达莫对局部冠状动脉血流动力学和代谢的急性影响
DOI：
10.1161/01.cir.64.2.333
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发表时间：
1981
期刊：
影响因子：
37.8
通讯作者：
C. Conti
中科院分区：
文献类型：
--
作者：
R. Feldman;W. Nichols;C. Pepine;C. Conti
本文观察了13例患者静脉注射潘生丁对急性冠脉血流动力学和代谢的影响。从冠状窦和心大静脉评估总左心室（LV）、前（由左前降支冠状动脉供应）和下（由回旋支和右冠状动脉供应）区域血流和代谢反应。根据冠状动脉造影结果，将LV区域灌注分类为潜在“正常”或“异常”。在潘生丁治疗前，正常和异常区域的冠状动脉流量、左室氧输送和乳酸提取相似。静脉推注潘生丁20 mg后1分钟内，冠脉总流量增加51%（P < 0.05）。注射后15分钟，流量持续增加。20分钟后，流量降至约对照水平。这种增加的总冠状动脉流量的主要成分是由正常区域的流量增加引起的（1分钟时为75%，p < 0.05）。无论是正常还是异常区域，平均区域LV氧输送和乳酸提取均无显著变化。然而，乳酸生产后，更经常发生双嘧达莫在异常地区。这些结果表明，在潘生丁诱导的充血，区域冠状动脉流量和代谢反应取决于供应LV区域的动脉的状态。血流和代谢的区域差异与心率、主动脉和LV压力的主要变化无关。
The acute coronary hemodynamic and metabolic effects of intravenous dipyridamole were studied in 13 patients. Total left ventricular (LV), anterior (supplied by the left anterior descending coronary artery) and inferior (supplied by circumflex and right coronary arteries) regional flows and metabolic responses were assessed from the coronary sinus and great cardiac vein. Perfusion to LV regions was classified as potentially “normal” or “abnormal,” based on coronary angiographic findings. Before dipyridamole, coronary flow, LV oxygen delivery and lactate extraction in both the normal and abnormal regions were similar. Within 1 minute after injection of 20 mg of dipyridamole by i.v. bolus, total coronary flow increased 51% (p < 0.05). Fifteen minutes after injection the flow increase persisted. Flow decreased to approximately control level by 20 minutes. The major component of this increased total coronary flow resulted from increased flow in normal regions (75% at 1 minute, p < 0.05). Mean regional LV oxygen delivery and lactate extraction were not changed significantly in either normal or abnormal regions. However, lactate production occurred more often after dipyridamole in abnormal regions. These results suggest that during dipyridamole-induced hyperemia, regional coronary flow and metabolic responses depend upon the status of the arteries supplying the LV region. Regional differences in flow and metabolism occur independent of major changes in heart rate and aortic and LV pressures.