Rentrop P, Schober B, Roskamm H, Reindell H, Schmuziger M, Faidutti B, Hahn C
Z Kardiol. 1976 May;65(5):405-16.
Actively contracting segments, preoperatively akinetic, were found in 8 of 63 patients, evaluated 6-12 months after aortocoronary surgery by coronary angiography. Ejection fraction was increased from 48.1% (S.D. 15.7) to 68.3% (S.D. 11.4). These patients are characterized by two simple clinical parameters: 1. All patients had angina pectoris at rest or at minimum exercise except for one; 2. preoperatively, there was a discrepancy between severe ventriculographic and discreet Ecg findings. These findings prove that myocardial function in coronary artery disease can be impaired at rest by ischemia, without clinical signs of coronary insufficiency, such as angina pectoris. Even severe impairment of left ventricular function is no contraindication for coronary artery surgery, if caused by reversible myocardial ischemia.
在63例患者中,有8例在主动脉冠状动脉搭桥手术后6至12个月通过冠状动脉造影进行评估时,发现术前无运动的节段出现了主动收缩。射血分数从48.1%(标准差15.7)提高到了68.3%(标准差11.4)。这些患者具有两个简单的临床特征:1. 除1例患者外,所有患者在休息或轻度运动时均有心绞痛;2. 术前,心室造影严重与心电图表现不明显之间存在差异。这些发现证明,冠状动脉疾病患者的心肌功能可因缺血在休息时受损,而无冠状动脉供血不足的临床体征,如心绞痛。即使左心室功能严重受损,如果是由可逆性心肌缺血引起,也不是冠状动脉手术的禁忌症。