[Chemical blockade of the cardiac autonomic nervous system. Effects on the coronary arterial vasomotor activity].
The results of cardiac plexectomy in spastic angina are controversial. This study was undertaken to evaluate the effects of blocking the cardiac autonomic nervous system (CANS) in this syndrome in 61 patients presenting with chest pain and angiographically normal coronary arteries. All patients underwent a methyl-ergometrine provocation test with a sequential protocol. They were then divided into two groups: Group 1 (13 patients): positive response to ergometrine. Group 2 (48 patients): negative response to ergometrine. Three sub-groups were identified: 2: 1: 9 patients with coronary spasm demonstrated by another method: 2: 2: 6 patients with myocardial infarction: 2: 3: 33 patients with chest pain alone. The results of these tests were compared with those obtained after blocking the CANS by intravenous injection over 3 minutes of an alpha and beta-blocker (labetalol 2 mg/kg) and a parasympathetic blocker (Atropine. 0.04 mg/kg). The CANS blockade was confirmed by two facts: the basal heart rate of 66.38 +/- 9.91 rose to ots intrinsic rate of 89.76 +/- 10.5 (p less than 0.01) and remained at that rate after ergometrine and trinitrate administration and myocardial ischaemia; changes in blood pressure were greater after CANS blockade: + 30.62 +/- 16.13 mmHg instead of + 8.62 +/- 0.33 mmHg after ergometrine (p less than 0.01) and -43.16 +/- 16.32 mmHg instead of -25.16 +/- 3.64 mmHg after trinitrate (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D001285:Atropine / Q000627:therapeutic use*; D001340:Autonomic Nerve Block; D001794:Blood Pressure / Q000187:drug effects; D003329:Coronary Vasospasm / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D004983:Ethanolamines / Q000627:therapeutic use*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007741:Labetalol / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
D004983:Ethanolamines; D001285:Atropine; D007741:Labetalol
Blocage chimique du systéme nerveux autonome cardiaque. Effets sur la vasomotricité artérielle coronaire.