Conditions for "Coronary Steal" Caused by Coronary Vasodilator in Man

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概要

• 論文の詳細を見る

• This study was undertaken to assess the conditions necessary to cause the "coronary steal" phenomenon in human subjects. We studied 42 patients (36 males, 6 females, ages 27-70 years) with known or suspected coronary artery diseases using continuous monitoring of the changes in blood pressure and electrocardiogram, thallium-201 myocardial imaging and selective coronary arteriography. Dipyridamole in a dose of 0.4mg/Kg was given as an intravenous infusion for 4min and thallium-201 was injected at the 4th minute after completion of the dipyridamole infusion. None of the 20 patients without significant coronary artery disease complained of anginal chest pain or showed ischemic S-T segment depression. Dipyridamole images showed no perfusion abnormalities in 17 of the 20 patients. On the other hand, in 4 of the 22 patients with significant coronary artery disease, anginal chest pain accompanied with S-T segment depression occurred after the dipyridamole infusion. Dipyridamole images showed perfusion abnormalities in 18 of the 22 patients. The 4 patients who experienced an anginal attack had 3 vessel disease on the coronary arteriogram and showed regional perfusion defects on scintigrams corresponding to the regions receiving collaterals. Before the onset of pain, the double product (heart rate × systolic arterial pressure) was unchanged significantly but there was a reduction in the systemic blood pressure. The overall data exhibit the following conditions under which attacks of angina pectoris are induced by dipyridamole: 1) the presence of multiple vessel disease, 2) a fall in systemic blood pressure, and 3) regional malperfusion caused by dipyridamole.

• International Heart Journal刊行会の論文

著者

• 小林 毅

  社会保険北海道健康保健管理センター

• Ando Joji

  Department Of Cardiovascular Midicine Hokkaido Univ. School Of Medicine Japan

• Ando Joji

  Department Of Biomedical Engineering Faculty Of Medicine University Of Tokyo

• Miyamoto Atsushi

  Department Of Cardiovascular Medicine School Of Medicine Hokkaido University

• Kobayashi Takeshi

  Department Of Biological Chemistry College Of Bioscience And Biotechnology Chubu University

• Kanamori Katsushi

  Department Of Cardiovascuiar Medicine Hokkaido University Schooi Of Medicine Hokkaido University

• Murakami Rinji

  Department Of Cardiovascular Medicine Hokkaido University School Of Medicine

• Matsumura Naoya

  Department Of Cardiology Hakodate Central General Hospital

• Yasuda Hisakazu

  Department O F Cardiovascular Medicine Hokkaido University School Of Medicine

• MURAKAMI Rinji

  Department of Cardiovascular Medicine, Hokkaido University, School of Medicine

• MIYAMOTO Atsushi

  Department of Cardiovascular Medicine, Hokkaido University, School of Medicine

• KOBAYASHI Takeshi

  Department of Cardiovascular Medicine, School of Medicine, Hokkaido University

• KOBAYASHI Takeshi

  Department of Cardiovascular Medicine, Hokkaido University, School of Medicine

• MATSUMURA Naoya

  Department of Cardiovascular Medicine, Hokkaido University, School of Medicine

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