Mikami M, Mikuniya A, Fujino Y, Higashiyama A, Takahashi M, Sato M, Sasaki M, Fukushi T, Onodera K, Oike Y
Second Department of Internal Medicine, Hirosaki University School of Medicine.
J Cardiol. 1992;22(1):43-50.
The purpose of this study was to investigate change in coronary venous oxygen saturation (CSO2-Sat) during percutaneous transluminal coronary angioplasty (PTCA) and to compare the results with those of standard 12-lead ECGs (s-ECG) and epicardial ECG induced using an intracoronary guidewire (ic-ECG). CSO2-Sat was measured continuously in 10 patients undergoing PTCA; 5 patients with lesions in the left anterior descending coronary artery (LAD), one with lesions in the left circumflex artery (LCX), and 4 with right coronary artery (RCA) lesions. The results were as follows: 1. In all 6 patients with stenotic lesions in the left coronary artery, CSO2-Sat decreased by 5 to 22% immediately after balloon inflation. Significant changes in ic-ECG (ST deviation > or = 0.1 mV) were observed in 5 of the 6 patients, while significant changes in s-ECG (ST deviation > or = 0.1 mV) were observed in only 3 of the 6 patients. The s-ECG did not seem to be sensitive enough to represent myocardial ischemia in the LCX. 2. The interval from the balloon inflation to the significant change was shorter for CSO2-Sat than for the ECGs in 4 of the 5 patients with LAD lesions, except Case 4. The recovery time of CSO2-Sat to the basal level on balloon deflation was longer than the recovery times of ic-ECG and s-ECG. 3. There was no significant change in the CSO2-Sat in 3 of the 4 patients undergoing PTCA for RCA lesions, while significant changes were observed in the ic-ECG and s-ECG in all 4 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是调查经皮腔内冠状动脉成形术(PTCA)期间冠状静脉血氧饱和度(CSO2-Sat)的变化,并将结果与标准12导联心电图(s-ECG)以及使用冠状动脉内导丝诱发的心外膜心电图(ic-ECG)的结果进行比较。对10例行PTCA的患者连续测量CSO2-Sat;5例患者左前降支冠状动脉(LAD)有病变,1例患者左旋支动脉(LCX)有病变,4例患者右冠状动脉(RCA)有病变。结果如下:1. 在所有6例左冠状动脉狭窄病变患者中,球囊扩张后立即CSO2-Sat下降了5%至22%。6例患者中有5例观察到ic-ECG有显著变化(ST段偏移≥0.1 mV),而6例患者中只有3例观察到s-ECG有显著变化(ST段偏移≥0.1 mV)。s-ECG似乎对代表LCX中的心肌缺血不够敏感。2. 除病例4外,5例LAD病变患者中有4例,CSO2-Sat从球囊扩张到显著变化的间隔时间比心电图短。球囊放气后CSO2-Sat恢复到基础水平的时间比ic-ECG和s-ECG的恢复时间长。3. 4例接受RCA病变PTCA的患者中有3例CSO2-Sat无显著变化,而所有4例患者的ic-ECG和s-ECG均有显著变化。(摘要截断于250字)