DETRIMENTAL EFFECT OF ERGONOVINE IN HYPERTROPHIC CARDIOMYOPATHY

麦角新碱对肥厚性心肌病的不利影响

• 批准号: 4694671
• 负责人: R O CANNON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/4694671
• 关键词: angina pectoris; arterioles; blood flow measurement; coronary artery; electronic pacemaker; heart circulation; heart metabolism; heart pharmacology; heart rate; human subject; hypertrophic myocardiopathy; intracardiac pressure; myocardial ischemia /hypoxia; vasoconstrictors

Patients with hypertrophic cardiomyopathy (HCM) frequently experience chest pain that occurs with variable threshold of onset and is often prolonged in duration. The study was designed to evaluate the effect of a pharmacologic vasoconstrictor agent, ergonovine, on the cornoary vasculature of patients with HCM. Twenty-three patients with HCM and a history of angina pectoris despite normal epicardial coronary arteries underwent a study of coronary flow, myocardial mechanics, and metabolism. During pacing to an average heart rate of 133,18 of the 23 patients experienced their typical chest pain. During pacing after the administration of ergonovine, 21 of 23 patients experienced chest pain. Despite a significantly higher blood pressure, the coronary blood flow at an average pacing rate of 138 beats/min was significantly lower than during pacing alone to a similar heart rate. There was no epicardial coronary artery narrowing during a repeat coronary arteriography. Thus, peak coronary flow decreases with ergonovine in patients with HCM, probably due to vasoconstriction of a maximally dilated microvascular bed, or vasoconstriction of prearteriolar small coronary arteries. Small vessel coronary vasoconstriction may explain many of the atypical features of angina pectoris in patients with HCM causing pain at rest or during variable levels of effort.

肥厚型心肌病（HCM）患者经常出现胸部 疼痛的发生具有可变的起始阈值，并且通常在 持续时间 这项研究旨在评估一种药理学 血管收缩剂麦角新碱对患者角膜血管的影响 关于HCM 23例有心绞痛病史的HCM患者 尽管正常的心外膜冠状动脉进行了冠状动脉研究， 血流、心肌力学和代谢。 在起搏过程中， 心率133次，23例患者中有18例出现典型胸部 痛苦 在给予麦角新碱后的起搏过程中，23例中有21例 患者出现胸痛。 尽管他的血液中 血压，冠状动脉血流在平均起搏率为138 次/分钟显著低于单独起搏期间， 心率 无心外膜冠状动脉狭窄， 重复冠状动脉造影。 因此，峰值冠状动脉流量随着 麦角新碱在HCM患者中，可能是由于血管收缩， 微血管床最大扩张或前小动脉血管收缩 小冠状动脉 小血管冠状血管收缩可能 解释了心绞痛患者的许多非典型特征， HCM导致休息时或不同程度的努力时疼痛。