Serruys P W, Hugenholtz P G, Brower R W
Arch Mal Coeur Vaiss. 1979 Mar;72(3):221-30.
In 56 patients operated on for coronary artery bypass grafting the relation between regional epicardial shortening, bypass flow, reactive hyperemia, and time postoperative was determined. Regional shortening in the newly perfused region was measured by a new technique employing four to six radiopaque markers sutured in pairs to the epicardium juxtaposed by 2 cm, and from 0 to 3 cm distal to the coronary anastomosis. Marker pairs were filmed sequentially at each follow up. Excluding dyskinesia, shortening fraction (ratio of shortening to maximum marker separation) for all graft regions at 1 week was 9.8 p. 100, 1 month 12.8 p. 100, 3 months 13.3 p. 100, and 6 months 13.9 p. 100. Average graft flow was 56 ml/mn and average reactive hyperemia was 25 p. 100 with 37 p. 100 of grafts having no response. There was a positive correlation between shortening fraction and flow, becoming significant (null hypothesis: r = 0) when reactive hyperemia exceeded 20 p. 100. Correlation was greatest at 1 week and 1 month, but became non-significant at 6 months implicating other factors such as new collateral development, bypass closure, new infarction, or altered medical therapy. It appears that bypass flow and reactive hyperemia do have a certain predictive value as to regional shortening up to 1 to 3 months postoperative.
对56例行冠状动脉搭桥手术的患者，测定了局部心外膜缩短、搭桥血流量、反应性充血与术后时间之间的关系。采用一种新技术测量新灌注区域的局部缩短情况，该技术是将四到六个不透射线的标记物成对缝合在心外膜上，相邻标记物间隔2厘米，位于冠状动脉吻合口远端0至3厘米处。在每次随访时依次拍摄标记物对。排除运动障碍后，所有移植区域在术后1周时的缩短分数（缩短长度与标记物最大间距的比值）为9.8%，1个月时为12.8%，3个月时为13.3%，6个月时为13.9%。平均移植血流量为56毫升/分钟，平均反应性充血为25%，37%的移植血管无反应。缩短分数与血流量之间呈正相关，当反应性充血超过20%时，这种相关性变得显著（原假设：r = 0）。相关性在1周和1个月时最大，但在6个月时变得不显著，这意味着存在其他因素，如新生侧支循环形成、搭桥血管闭塞、新发梗死或药物治疗改变。似乎在术后1至3个月内，搭桥血流量和反应性充血对局部缩短确实具有一定的预测价值。
