ROLE OF SINUS NODE ARTERY DISEASE IN SICK SINUS SYNDROME IN INFERIOR WALL ACUTE MYOCARDIAL-INFARCTION
ROLE OF SINUS NODE ARTERY DISEASE IN SICK SINUS SYNDROME IN INFERIOR WALL ACUTE MYOCARDIAL-INFARCTION
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DOI：
10.1016/0002-9149(91)90923-9
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发表时间：
1991-06-01
影响因子：
2.8
通讯作者：
ANTONIOLI, GE
中科院分区：
文献类型：
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作者：
ALBONI, P;BAGGIONI, GF;ANTONIOLI, GE
本研究旨在评估窦房结 (SN) 动脉疾病在下壁急性心肌梗死 (AMI) 患者病态窦房结综合征 (SSS) 发病机制中的可能作用。 对 23 名患有 SSS 和既往下壁 AMI 的研究患者（平均年龄 60 岁）和另外 23 名窦率正常且既往下壁 AMI 的对照患者（平均年龄 57 岁）进行了 SN 的冠状动脉造影和电生理学研究，包括基础状态和药物自主神经阻滞后。 13 名研究患者 (56%) 和 8 名对照患者 (34%) 出现 SN 动脉（或其起源近端）狭窄 > 50% (p < 0.05)。 在研究组中，6 名 SN 动脉严重狭窄（狭窄大于或等于 75%）患者中，有 5 名（83%）存在固有心率异常；7 名中度狭窄（狭窄 50% 至 75%）患者中，有 3 名（43%）存在固有心率异常；10 名轻微狭窄（狭窄小于 50%）的患者中，有 3 名（30%）存在固有心率异常。 在研究组中，SN测量值（心率、校正SN恢复时间和窦房传导时间）与SN动脉狭窄严重程度之间的相关性在自主神经阻滞后良好（r在0.59和0.64之间），而在基础状态下相关性较差。 这些数据为 SN 动脉疾病在下壁 AMI 患者 SSS 发病机制中的作用提供了证据。
This study was undertaken to evaluate a possible role of sinus node (SN) artery disease in the pathogenesis of sick sinus syndrome (SSS) in patients with an inferior wall acute myocardial infarction (AMI). Coronary angiography and electrophysiologic studies of the SN, both in the basal state and after pharmacologic autonomic blockade, were performed in 23 study patients (mean age 60 years) with SSS and a previous inferior wall AMI and in another 23 control patients (mean age 57 years) with normal sinus rate and a previous inferior AMI. Stenosis of the SN artery (or that proximal to its origin) > 50% was present in 13 study patients (56%) and in 8 control patients (34%) (p < 0.05). In the study group, the intrinsic heart rate was abnormal in 5 of the 6 patients (83%) with severe SN artery stenosis (greater-than-or-equal-to 75% narrowing), in 3 of the 7 (43%) with moderate stenosis (50 to 75% narrowing) and in 3 of the 10 (30%) with insignificant stenosis (< 50% narrowing). In the study group, the correlation between the SN measures (heart rate, corrected SN recovery time and sinoatrial conduction time) and the severity of SN artery stenosis was good after autonomic blockade (r between 0.59 and 0.64) and poor in the basal state. These data provide evidence for a role of SN artery disease in the pathogenesis of SSS in patients with an inferior wall AMI.