Dipyridamole および Propranolol の冠循環動態に対する影響
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Since the discovery of antianginal effects of ni- trates by BRUNTON in 1867, nitrate preparations have been the first choice of drugs in the treatment of anginal attack. Although the effects of this drug have been well recognized in the practical medicine, the exact mechanism of the antianginal effects is still remaining obscure. Since AHLQUIST's hypothesis in 1948 concerning to the existence of two kinds of sympathetic receptor, alpha and beta, many kinds of beta-blocking agent have been synthesized. Propranolol synthesized by BLACK and his coworkers in 1964 has been used for angina pectoris in a hope to reduce work load to the heart. On the other hand, various kinds of so-called "coronary artery dilator" which are claimed to have significant coronary dilator action have been synthesized during past twenty years. Although their coronary dilator action have not yet been well verified in clinical practice. Dipyridamole is one of these drugs, developed by FISCHER and ROCH in 1951 is widely used for ischemic heart disease in Japan. I have been studying the effects of Dipyridamole and Propranolol to coronary circulation inhuman subjects both with and without coronary heart disease. The purpose of this paper is to report the effects of these two drugs on human subjects by means of coronary sinus catheterization technique. Materials and Methods: Ten cases of coronary heart disease were chosen for the study. All the cases are male and their age ranged between 47 and 74, mean of 57.6. Sixteen cases of noncoronary heart disease were studied as control group, aged between 14 and 46, with mean of 26.8. Cases were brought into catheterization room in the early morning, and subjected to the study during the postabsorptive status. Coronary sinus catheterization was performed after more than 30 minutes bed rest. Simultaneous sampling both from coronary sinus and ,brachial artery was done during steady state at rest, and 20 minutes after the administration of drugs. 10 mg Dipyridamole in were given through the catheter intubated into coronary sinus it 7 cases of coronary heart disease and 10 cases of control group. On the other hand, 2mg Propranolol was given to 3 cases of coronary heart disease and 6 cases of control group. Blood samples were analyzed into O_2 and CO_2 content in Vol% by the VAN SLYKE-NEILL's manometric method and. also measured of PO_2 and PCO_2 using CLARK and SEVERINGHOUSE' type electrode technique and also by RILEY's bubble equillibrium method. Oxygen saturation of coronary sinus blood (S_sO_2) was calculated as per cent of oxygen content of sinus sample to oxygen capacity of the whole blood. Myocardial oxygen extraction rate was expressed as a ratio in per cent of arterio-coronary sinus oxygen difference to arterial oxygen content (ΔO_2/AO_2).
- 社団法人日本循環器学会の論文
- 1971-01-20
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