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急性心筋梗塞における責任冠動脈自然開通例の臨床的特徴
https://kindai.repo.nii.ac.jp/records/2002080
https://kindai.repo.nii.ac.jp/records/200208036e0b17b-a533-4b95-9f60-47c4f3c00a52
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
AN00063584-19930925-0381.pdf (1.5 MB)
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| Item type | ☆紀要論文 / Departmental Bulletin Paper(1) | |||||||||
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| 公開日 | 2024-12-05 | |||||||||
| タイトル | ||||||||||
| タイトル | 急性心筋梗塞における責任冠動脈自然開通例の臨床的特徴 | |||||||||
| 言語 | ja | |||||||||
| タイトル | ||||||||||
| タイトル | Clinical features of patients with spontaneous recanalization of the infarct-related artery during evolving myocardial infarction | |||||||||
| 言語 | en | |||||||||
| 著者 |
秋山, 浩之
× 秋山, 浩之
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| 言語 | ||||||||||
| 言語 | jpn | |||||||||
| キーワード | ||||||||||
| 主題 | acute myocardial infarction, spontaneous recanalization, angina pectoris, chest pain, vasospasm, nitroglycerin | |||||||||
| 資源タイプ | ||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||||||
| 資源タイプ | departmental bulletin paper | |||||||||
| 出版タイプ | ||||||||||
| 出版タイプ | AM | |||||||||
| 出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||||||
| 出版者 名前 | ||||||||||
| 出版者 | 近畿大学医学会 | |||||||||
| 言語 | ja | |||||||||
| bibliographic_information |
ja : 近畿大学医学雑誌 en : Medical Journal of Kinki University 巻 18, 号 3, p. 381-401, 発行日 1993-09-25 |
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| ISSN | ||||||||||
| 収録物識別子タイプ | PISSN | |||||||||
| 収録物識別子 | 03858367 | |||||||||
| 内容記述 | ||||||||||
| 内容記述タイプ | Abstract | |||||||||
| 内容記述 | Acute myocardial infarction (AMI) with spontaneous recanalization (SR) of infarct-related coronary artery (IRCA) has distinctly different clinical features compared to AMI with occluded arteries. To clarify the pathogenesis of SR, the incidence of SR, anginal episodes prior to the onset of infarction, the character of chest pain at onset, vasodilator response to nitroglycerin in IRCA, and infarct size were studied in 296 patients (pts) with AMI. Pts were devided into three groups, TIMI 0 : 172 with complete occlusion of the artery at the initial coronary angiogram, TIMI 1, 2 : 57 with subtotal occlusion and TIMI 3 : 67 with SR. The incidence of SR was 20.3% when coronary angiograms were performed 0-4 hrs after onset, 22.2% at 4-6 hrs, 19.7% at 6-12 hrs, 24.0% at 12-24 hrs and 36.0% more than 24 hrs later. This indicates that the incidence of SR was not dependent on the elapsed time after onset. IRCA may be patent very early after onset and late SR is not more frequent than that occurring within 4 hrs after onset. AMI with SR was characterized by a high incidence of angina before the onset of infarction which was associated with increased coronary vasomotor tone (angina at rest : 28.6%, variable-threshold angina : 38.1%, others : 33.3%). However, AMI with complete occlusion showed only 5.4% of angina at rest and 10.8% of variable-threshold angina. Duration of chest pain was more than 2 hrs in 91.3% of patients with complete occlusion, while 48.6% of patients with SR had chest pain for less than 2 hrs. This would indicate that in SR complete occlusion persisted for a very short time after onset. Intermittent chest pain at onset occurred in 38.8% of SR, suggesting coronary occlusion was intermittent, while only 8.4% of patients with complete occlusion had intermittent pain. Coronary vasodilator response to intracoronary nitroglycerin was measured using the automatic edge detection system. Vasodilatation of the proximal normal adjacent segment to the stenotic lesion of IRCA was only 4.0±0.6% in complete occlusion, while it was significantly increased (20.7±2.6%) in SR. This would indicate that IRCA in SR was spastic during the initial coronary angiogram. Infarct size was larger in complete occlusion than in the successfully reperfused group and SR as determined by serum creatine kinase activity, number of abnormal Q waves, wall motion abnormality on 2-D echocardiogram and left ventriculogram. The infarct size in SR also was smaller than that in the successfully reperfused group, suggesting that IRCA may be patent in SR far earlier than in the successfully reperfused group. In conclusion, IRCA of SR is either recanalized very early after onset or has an increased coronary vasomotor tone, so-called spasm, at the onset of AMI. | |||||||||
| 言語 | en | |||||||||
| 内容記述 | ||||||||||
| 内容記述タイプ | Other | |||||||||
| 内容記述 | 本文データはCiNiiから複製したものである。 | |||||||||
| 言語 | ja | |||||||||
