FREQUENCY OF PROVOKED CORONARY ARTERIAL SPASM IN 1089 CONSECUTIVE PATIENTS UNDERGOING CORONARY ARTERIOGRAPHY
FREQUENCY OF PROVOKED CORONARY ARTERIAL SPASM IN 1089 CONSECUTIVE PATIENTS UNDERGOING CORONARY ARTERIOGRAPHY
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DOI：
10.1161/01.cir.65.7.1299
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发表时间：
1982-01-01
期刊：
影响因子：
37.8
通讯作者：
LAURENT, JM
中科院分区：
文献类型：
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作者：
BERTRAND, ME;LABLANCHE, JM;LAURENT, JM
在连续1089例接受冠状动脉造影术的患者中，确定了0.4 mg甲基麦角碱引起的冠状动脉痉挛的发生率。在常规冠状动脉造影后进行测试。受试者包括典型和非典型心绞痛患者、近期发生心肌梗死的患者以及瓣膜病或充血性心肌病患者。排除自发性痉挛、左主干狭窄或严重3支血管病变的患者。患者（134例）出现局灶性痉挛。局灶性痉挛在非典型心前区疼痛（1.2%）、劳累性心绞痛（4.3%）、瓣膜病（1.95%）或心肌病（0%）患者中并不常见。它最常发生在静息时心绞痛患者中，较少发生在静息和运动诱发的心绞痛患者中。在最近的透壁性梗死患者中，有20%的患者出现痉挛，但在梗死后的研究中，只有6.2%的患者出现痉挛。60%的患者痉挛叠加在固定的动脉粥样硬化病变上。未发生严重并发症。尽管在本研究中接受激发试验的患者并不能代表所有冠状动脉疾病患者，但发生痉挛的患者中有20%发生了冠状动脉事件，15%主诉胸痛。
The incidence of coronary artery spasm provoked by 0.4 mg of methergine in 1089 consecutive patients undergoing coronary angiography was established. The test was performed after routine coronary arteriography. Subjects included patients with angina, both typical and atypical, patients who had recently had myocardial infarction and patients with either valvular disease or congestive cardiomyopathy. Patients with spontaneous spasm, left main narrowing or severe 3-vessel disease were excluded. Patients (134) experienced focal spasm. Focal spasm was uncommon in patients with atypical precordial pain (1.2%), angina of effort (4.3%), valvular disease (1.95%) or cardiomyopathy (0%). It occurred most often in patients with angina at rest and less often in patients with angina both at rest and induced by exercise. Spasm was provoked in 20% of patients with recent transmural infarction, but in only 6.2% of patients studied later after infarction. Spasm was superimposed on fixed atherosclerotic lesions in 60% of the patients. No serious complications were encountered. Although the patients who underwent provocation tests in this study are not representative of all patients with coronary artery disease, spasm occurred in 20% of patients who experienced a coronary event and in 15% of patients who complained of chest pain.