Alpha-adrenoceptor-mediated coronary artery spasm.
Alpha-adrenoceptor-mediated coronary artery spasm.
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α-肾上腺素受体介导的冠状动脉痉挛。
DOI：
10.1001/jama.236.9.1018
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发表时间：
1976
期刊：
影响因子：
--
通讯作者：
Freeman Mr
中科院分区：
文献类型：
--
作者：
Levene Dl;Freeman Mr
一位41岁的女性心绞痛患者的选择性冠状动脉造影显示，硝酸盐治疗未影响左右冠状动脉主干近端狭窄。为了排除冠状动脉痉挛，重复了该研究，观察到右冠状动脉狭窄的显著增加。这90%的狭窄几乎取消了预处理静脉给予盐酸酚妥拉明。与给予安慰剂的匹配对照组相比，用盐酸酚苄明延长α-肾上腺素受体阻滞剂改善了患者的运动耐量和运动后心电图异常。这些观察结果表明，α-肾上腺素受体介导的冠状动脉痉挛可能模仿冠状动脉造影的器质性病变，可能是某些患者心绞痛发病机制的一个因素。
Selective coronary arteriography performed on a 41-year-old woman with angina pectoris demonstrated proximal stenosis of the right and left main coronary arteries that was unaffected by nitrate therapy. To exclude coronary artery spasm, the study was repeated, and a striking increase in the narrowing of the right coronary artery was observed. This 90% stenosis was virtually abolished by pretreatment with intravenously given phentolamine hydrochloride. Prolonged alpha-adrenoceptor blockade with phenoxybenzamine hydrochloride improved the patient's exercise tolerance and postexercise electrocardiographic abnormalities when compared to therapy in matched controls given placebo. These observations suggest that alpha-adrenoceptor-mediated coronary artery spasm may mimic organic lesions at coronary arteriography and may be a factor in the pathogenesis of angina pectoris in some patients.