Role of Autonomic Nervous System in the Pathogenesis of Prinzmetal's Variant
نویسندگان
چکیده
In ten patients with Prinzmetal's variant form of angina the effects of various drugs were assessed: subcutaneous injection of methacholine (10 mg), atropine (0.7 mg), and epinephrine (0.7 mg); intravenous infusion of isoproterenol (20-25 ,ug/min); and in the three of the above patients who were having recurrent spontaneous attacks at the time of the examination, oral administration of atropine (0.6-1.2 mg), propranolol (30-90 mg), and phenoxybenzamine (10 mg in one patient). Master's triple two-step test and selective coronary arteriography were done on all the patients. In the three patients who were having spontaneous attacks at the time of the examination, the administration of methacholine induced the attacks and that of atropine suppressed the attacks. Epinephrine induced the attacks in two patients and propranolol was without effect in suppressing the attacks. Phenoxybenzamine (in one patient) suppressed the attacks. Neither Master's triple two-step test nor isoproterenol infusion precipitated the attacks, though heart rate increased to more than 110 beats/min and 160 beats/min respectively in all the patients. Coronary arteriograms were normal in seven of the ten patients. It is concluded that enhanced activity of the parasympathetic nervous system, which occurs at rest, is involved in the initiation of the attack by stimulating the sympathetic nerve which in turn probably induces
منابع مشابه
Role of autonomic nervous system in the pathogenesis of Prinzmetal's variant form of angina.
In ten patients with Prinzmetal's variant form of angina the effects of various drugs were assessed: subcutaneous injection of methacholine (10 mg), atropine (0.7 mg), and epinephrine (0.7 mg); intravenous infusion of isoproterenol (20-25 ,ug/min); and in the three of the above patients who were having recurrent spontaneous attacks at the time of the examination, oral administration of atropine...
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and clinical illustrations. Am J Cardiol 90: 624, 1978 12. Guazzi M, Polese A, Fiorentini C, Magni F, Bartorelli C: Left ventricular performance and related haemodynamic changes in Prinzmetal's variant angina pectoris. Br Heart J 33: 84, 1971 13. Maseri A, Mimmo R, Chierchia S, Marchesi C, Pesola A, L'Abbate A: Coronary artery spasm as a cause of acute myocardial ischemia in man. Chest 68: 625,...
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BACKGROUND The autonomic nervous system is reported to be involved in the pathogenesis of vasospastic angina (VSA). Studies based on heart rate variability analysis have shown conflicting results with both a reduction and an enhancement of sympathetic nervous system (SNS) activity in patients with Prinzmetal's variant angina, but direct assessment has never been performed. The aim of our study ...
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