AVSEP systemによる異型狭心症の発作発現機序に関する研究
スポンサーリンク
概要
- 論文の詳細を見る
In order to elucidate the pathogenesis of variant angina, 24 hours' electrocardiograms using AVSEP system, predisposing factors and the onset of anginal attack were studied in 20 patients with Prinzmetal's variant form of angina (VA), and these findings were compared with those in 50 non cardiac adults (C), and 7 patients with effort angina (EA) and 4 with resting angina (RA), who had depressed ST segment on attack. Results obtained were as following : 1) The ST elevation of VA occured mostly during sleep and/or one to two hours prior to sleep or just after awakening. 2) The ST depression of EA was found only in daily active state, but those of RA were found in sleep or at rest, if it is in day time. 3) Chest pain was preceded by ST changes in all groups, but ST changes without chest pain were also observed in 40 of 72 attacks (58%) in VA, 18 of 40 (45%) in EA respectively, however, these findings were not observed in RA. 4) The increase of heart rate in VA did not start prior to the onset of ST elevation, but the heart rate was only slightly increased during the episode of ST elevation. On the contrary, both in EA and RA, the heart rate increased 18% to 28% prior to the onset of ST depression, which increased further during ST depression. From these findings it was suggested that the onset of attack in VA developed under the condition of no increase of oxygen consumption in heart. 5) It was postulated from the results of changing heart rate in 24 hours ECG monitoring in non cardiac adults that the coronary spasmus might be brought up from the imbalance of autonomic nervous system, stimulation of the sympathetic activity under vagotonic state. 6) Arrhythmias, especially run of ventricular premature beats, ventricular tachycardia and A-V block, were highly observed during the ST elevation in VA. From these results, it is postulated that the imbalance of autonomic nervous system and a resultant coronary spasmus will play an important role in pathogenesis of variant angina, and arrhythmia may be one of the main cause of sudden death in VA.
- 神戸大学の論文