冠攣縮性狭心症の気道過敏性について

概要

論文の詳細を見る
To determine whether there is a generalized cholinergic hyperreactivity in vasospastic angina (VSA), we examined airway hyperresponsiveness (AH) to methacholine and compared it with coronary spasticity to acetylcholine in 40 patients complaining of chest pain without ≧75% stenosis at coronary angiography. Twenty-six patients with ≧90% stenosis by acetylcholine with chest pain and/or ischemic changes in electrocardiogram were defined as VSA and the other 14 patietns, chest pain syndrome (CP), respectively. Coronary spasticity was evaluated with maximum diameter reduction induced by acetylcholine. AH to methacholine was measured in terms of minimum dose (Dmin), defined as the cumulative dose at the point where respiratory conductance began to decrease. Those who had Dmin lower than 50 units were defined as subjects with AH. The incidence of AH in VSA (73%) was significantly higher than that in CP (21%) (p< 0.01) and the geometric mean of log Dmin in VSA (0.71 units) was significantly lower than that in CP (1.27 units) (p<0.005). There was a significant inverse relation between the percentage of maximum coronary diameter reduction and log Dmin in VSA alone (p<0.01) and in all subjects (p<0.0001). Therefore, a generalized hyperreactivity of vascular and nonvascular smooth muscle, including through cholinergic mechanism, may exist in VSA.
東京女子医科大学の論文
1996-11-25