冠血管作働薬の冠副行循環に及ぼす影響(逆行性血流量測定法による実験的研究)

The effects of coronary vasoactive drugs on coronary collateral were studied in anesthetized open-chest dogs. The circumflex coronary artery was gradually occluded by an aneroid constrictor. Four to eight weeks later, retrograde coronary blood flow from the peripheral coronary artery and other parameters were studied. The results were as follows. 1) Propranolol (0.2 mg/kg) decreased myocardial oxygen consumption represented as pressure rate product and increased peripheral coronary vascular resistance slightly. Retrograde coronary blood flow decreased significantly. The effect of propranolol was to improve the imbalance between myocardial oxygen demand and supply. 2) Nitroglycerin (20 μg/kg) caused a reduction in preload and myocardial oxygen consumption. Retrograde coronary blood flow did not increase. 3) Diltiazem (0.15 mg/kg) decreased myocardial oxygen consumption. Retrograde coronary blood flow was not significantly changed. 4) Isoproterenol (0.2 μg/kg) aggravated the myocardial oxygen demand-supply relationship. 5) There was a significant reduction in the regional myocardial shortening in the ischemic area compared with the control area. The response of regional myocardial shortening to the drugs in the ischemic area, however, was similar to that in the control area.