CORONARY-ARTERY SPASM IS A MAJOR CAUSE OF SUDDEN CARDIAC-ARREST IN SURVIVORS WITHOUT UNDERLYING HEART-DISEASE
CORONARY-ARTERY SPASM IS A MAJOR CAUSE OF SUDDEN CARDIAC-ARREST IN SURVIVORS WITHOUT UNDERLYING HEART-DISEASE
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DOI：
10.1097/00019501-199302000-00008
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发表时间：
1993-02-01
影响因子：
1.8
通讯作者：
SHIBATA, A
中科院分区：
文献类型：
--
作者：
IGARASHI, Y;TAMURA, Y;SHIBATA, A
背景：冠状动脉痉挛在心脏骤停复苏后无基础疾病患者中的作用尚不明确。本研究探讨了心脏骤停的原因，并比较了有基础心脏病（I组）和无基础心脏病（II组）患者的病因和预后差异。方法：25例心脏骤停幸存者根据有无基础心脏病分为两组。为探讨心脏骤停的原因，我们进行了麦角新碱试验和电生理检查。结果：I组15例患者中13例出现电生理异常，10例无心脏病史。第二组中，观察期间有4例患者发生冠状动脉痉挛自发发作，其余6例患者中有3例诱发冠状动脉痉挛。组I中有4例患者在平均随访32+/-23个月期间发生心脏事件，而组II中无患者在中位随访32个月（范围10至72个月）时再次发生心脏骤停。结论：电生理研究确定了15例潜在心脏病患者中13例的潜在原因。冠状动脉痉挛参与了无明确基础心脏病幸存者心脏骤停的发病机制。
Background: The role of coronary spasm in underlying disease-free patients who were resuscitated from sudden cardiac arrest remained uncertain. This study investigated the cause of cardiac arrest, and the etiologic and prognostic differences were compared between patients with underlying heart disease (group I) and those patients without underlying heart disease (group II).Methods: Twenty-five survivors of sudden cardiac arrest were classified into two groups according to the presence or absence of underlying heart disease. To investigate the cause of cardiac arrest, we performed ergonovine testing and electrophysiologic study. Fifteen of the patients had underlying heart disease, while 10 did not.Results: Electrophysiologic abnormalities were found in 13 of the 15 patients in group I. In group II, spontaneous attack of coronary spasm occurred in four patients during the observation period, and coronary spasm was induced in three of the remaining six patients. Four patients in group I had a cardiac event during a mean follow-up period of 32+/-23 months, whereas no patients in group II had recurrence of sudden cardiac arrest at a median follow-up of 32 months (range, 10 to 72 months).Conclusions: Electrophysiologic study identified a potential cause in 13 of 15 patients with underlying heart disease. Coronary spasm was involved in the pathogenesis of sudden cardiac arrest in survivors without identifiable underlying heart disease.