Kume Teruyoshi, Akasaka Takashi, Kawamoto Takahiro, Watanabe Nozomi, Yoshitani Hidetoshi, Akiyama Maki, Koyama Yuji, Neishi Yoji, Tsukiji Miwako, Yoshida Kiyoshi
Division of Cardiology, Kawasaki Medical School, Matsushima 577, Kurashiki, Okayama 701-0192.
J Cardiol. 2004 Mar;43(3):123-9.
This study assessed the relationship between coronary flow reserve and functional recovery of left ventricular wall motion in patients with tako-tsubo-like transient left ventricular dysfunction.
Coronary flow reserve was measured using the Doppler guide wire technique in the left descending coronary artery in nine consecutive patients (three men, six women, mean age 71 +/- 11 years) with tako-tsubo-like transient left ventricular dysfunction. Regional wall motion was analyzed to estimate anterior wall motion score index (anterior WMSI) by transthoracic echocardiography on admission and 3 weeks after the onset of symptoms.
Anterior WMSI was 2.2 +/- 0.4 on admission and improved to 1.4 +/- 0.5 at 3 weeks later (p < 0.001). Coronary flow reserve on admission was not correlated to the anterior WMSI on admission (r = 0.19, p = 0.63). However, coronary flow reserve on admission was correlated to the improvement in anterior WMSI (r = 0.74, p = 0.02).
Coronary microcirculation is damaged in acute phase of tako-tsubo-like transient left ventricular dysfunction. The severity of coronary microvascular dysfunction influences the degree of left ventricular wall motion recovery.
本研究评估了应激性心肌病样短暂性左心室功能障碍患者的冠状动脉血流储备与左心室壁运动功能恢复之间的关系。
采用多普勒导丝技术测量了9例连续的应激性心肌病样短暂性左心室功能障碍患者（3例男性，6例女性，平均年龄71±11岁）左冠状动脉前降支的冠状动脉血流储备。入院时及症状发作后3周，通过经胸超声心动图分析局部壁运动，以评估前壁运动评分指数（前壁WMSI）。
入院时前壁WMSI为2.2±0.4，3周后改善至1.4±0.5（p<0.001）。入院时的冠状动脉血流储备与入院时的前壁WMSI无相关性（r=0.19，p=0.63）。然而，入院时的冠状动脉血流储备与前壁WMSI的改善相关（r=0.74，p=0.02）。
应激性心肌病样短暂性左心室功能障碍急性期冠状动脉微循环受损。冠状动脉微血管功能障碍的严重程度影响左心室壁运动恢复的程度。
