ACUTE CORONARY HEMODYNAMIC-RESPONSE TO CIGARETTE-SMOKING IN PATIENTS WITH CORONARY-ARTERY DISEASE
ACUTE CORONARY HEMODYNAMIC-RESPONSE TO CIGARETTE-SMOKING IN PATIENTS WITH CORONARY-ARTERY DISEASE
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DOI：
10.1016/s0735-1097(84)80344-7
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发表时间：
1984-01-01
影响因子：
24
通讯作者：
TEICHHOLZ, LE
中科院分区：
文献类型：
--
作者：
KLEIN, LW;AMBROSE, J;TEICHHOLZ, LE
吸烟引起的冠状动脉血流量和阻力的急性变化还没有被准确地确定。为了确定影响这种反应的因素，测量了16例冠状动脉疾病患者（I组）和6例无血管造影可检测到的冠状动脉疾病患者（II组）的冠状窦血流量。7名患者（IA组）有重度（≥ 10）75%）近端左冠状动脉病变和9例患者（IB组）有显着的远端病变，近端狭窄50%或更少。第一组的总体增幅较小（. 1.6 .+-. 5.3%）比组II（0.1%）在冠状窦血流中增加。7.7 .+-. 6.1%（P < 0.05）。冠状动脉阻力总体上增加（. 2.7 .+-. 5.3%），但在组I中降低（下降）。2.4 .+-.Ⅱ组为3.4%（P < 0.05）。与IB组相比，IA组中的患者具有非常显著的冠状动脉阻力增加（高于IB组）。7.0 .+-. 4.2% vs.dwnarw. 0.9 .+-. 2.6%（P < 0.001）。冠状窦流量趋于减少（下降）。1.2 .+-. 4.6%），但增加（. 3.8 .+-. IB组为5.1%（P = 0.06）。吸烟明显增加冠状动脉疾病患者的冠脉阻力。观察到严重近端狭窄患者的影响大于远端狭窄患者。吸烟明显增加狭窄部位的冠状动脉张力，限制与受影响血管床大小成比例的冠状动脉血流反应。
The acute changes in coronary blood flow and coronary resistance that occur in response to cigarette smoking have not been accurately determined. To define the factors that affect this response, coronary sinus blood flow was measured in 16 patients (group I) with coronary artery disease and in 6 patients (group II) without angiographically detectable coronary disease. Seven patients (group IA) had severe (.gtoreq. 75%) proximal left coronary lesions and 9 patients (group IB) had significant distal lesions with 50% or less proximal stenoses. Group I had a smaller overall increase (.uparw. 1.6 .+-. 5.3%) in coronary sinus blood flow than did group II (.uparw. 7.7 .+-. 6.1%) (P < 0.05). Coronary resistance increased overall (.uparw. 2.7 .+-. 5.3%) in group I but decreased (.dwnarw. 2.4 .+-. 3.4%) in group II (P < 0.05). Patients in group IA had a highly significant increase in coronary resistance as compared with group IB (.uparw. 7.0 .+-. 4.2% vs. .dwnarw. 0.9 .+-. 2.6%) (P < 0.001). Coronary sinus flow tended to decrease (.dwnarw. 1.2 .+-. 4.6%) in group IA but to increase (.uparw. 3.8 .+-. 5.1%) in group IB (P = 0.06). Smoking apparently increases coronary resistance in patients with coronary artery disease. A greater impact is observed in patients with a severe proximal stenosis than in those with a distal stenosis. Smoking evidently increases coronary artery tone at the site of the stenosis, limiting the coronary flow response proportionally to the size of the affected vascular bed.