左胸廓内动脉移植物与大隐静脉移植物流变学参数的比较。

Comparison of the rheologic parameters in left internal thoracic artery grafts with those in saphenous vein grafts.

作者信息

Isobe Naoki, Kaneko Tatsuo, Taniguchi Koichi, Oshima Shigeru

机构信息

Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.

出版信息

Circ J. 2005 Jun;69(6):700-6. doi: 10.1253/circj.69.700.

DOI:10.1253/circj.69.700

PMID:15914949

Abstract

BACKGROUND

Left internal thoracic artery (LITA) grafts have superior patency to saphenous vein grafts (SVG). Because shear stress augments the release of nitric oxide throughout the LITA endothelium, shear stress and shear rate in coronary artery bypass grafts (CABG) may play an important role in the higher patency, so the aim of the present study was to evaluate and compare the rheologic parameters in CABG using LITA and SVG.

METHODS AND RESULTS

Rheologic examinations were done in 197 patients using a vacuum-suction glass tube viscometer after CABG surgery was completed. Shear stress and shear rate were calculated from the geometry of the graft, blood flow in the graft and blood viscosity. Of 197 patients, 177 underwent LITA grafting to the left anterior descending artery (LAD) and 160 had SVG anastomosis to coronary arteries. Mean wall shear stress in the LITA grafts to the LAD (13.8+/-1.0 dyne/cm2) was nearly 4-6-fold larger than that in the SVG grafts. Mean shear rate (559.1+/-57.0 s(-1)) of LITA-LAD grafts was approximately 2-3-fold higher than that of SVG.

CONCLUSION

These results suggest that high wall shear stress and shear rate play an important role in the higher patency rate of LITA grafts.

摘要

背景

左乳内动脉（LITA）移植物的通畅率优于大隐静脉移植物（SVG）。由于剪切应力可增加整个LITA内皮细胞一氧化氮的释放，冠状动脉旁路移植术（CABG）中的剪切应力和剪切速率可能在较高的通畅率中发挥重要作用，因此本研究的目的是评估和比较使用LITA和SVG的CABG中的流变学参数。

方法和结果

在197例患者完成CABG手术后，使用真空抽吸玻璃管粘度计进行流变学检查。根据移植物的几何形状、移植物中的血流和血液粘度计算剪切应力和剪切速率。在197例患者中，177例接受了LITA移植至左前降支动脉（LAD），160例进行了SVG与冠状动脉的吻合。LITA移植至LAD的平均壁剪切应力（13.8±1.0达因/平方厘米）比SVG移植物中的平均壁剪切应力大近4至6倍。LITA-LAD移植物的平均剪切速率（559.1±57.0秒-1）比SVG的平均剪切速率高约2至3倍。