Hasanović Aida
Institute of Anatomy, University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina.
Bosn J Basic Med Sci. 2008 Nov;8(4):304-8. doi: 10.17305/bjbms.2008.2881.
The present study evaluated the impact of the angiographically documented collaterals on regional myocardial perfusion measured by 201thallium scintigraphy in patients with a chronic total occlusion. The study included 60 patients with chronic total occlusion who underwent rest-stress myocardial perfusion scintigraphy and coronary angiography. All patients had angiographic evidence of coronary collaterals. Patients were divided into two groups: group one had well-developed coronary collateral vessels (n=35) and group II had poor coronary collateral development (n=25). Patients with chronic total occlusion had severe and extensive stress-induced myocardial perfusion defects regardless of the grade of angiographic coronary collaterals. The perfusion defects in the group with good collaterals were predominantly reversible, suggesting that coronary collaterals preserved myocardial viability in the regions subtended by a total coronary occlusion. A significant correlation between good collaterals with complete protection and poor collaterals with no protection was noted. Our results demonstrate a protective effect of collaterals on myocardial perfusion during coronary occlusion. The effective angiographic collaterals may prevent resting regional wall motion abnormalities but do not appear to protect against stress-induced perfusion defect.
本研究评估了血管造影记录的侧支循环对慢性完全闭塞患者通过铊-201 心肌灌注显像测量的局部心肌灌注的影响。该研究纳入了 60 例接受静息-负荷心肌灌注显像和冠状动脉造影的慢性完全闭塞患者。所有患者均有冠状动脉侧支循环的血管造影证据。患者被分为两组：第一组有发育良好的冠状动脉侧支血管（n = 35），第二组冠状动脉侧支发育不良（n = 25）。慢性完全闭塞患者无论血管造影显示的冠状动脉侧支分级如何，均有严重且广泛的负荷诱导心肌灌注缺损。侧支良好组的灌注缺损主要是可逆的，这表明冠状动脉侧支在冠状动脉完全闭塞所涉及的区域保留了心肌活力。注意到具有完全保护作用的良好侧支与无保护作用的不良侧支之间存在显著相关性。我们的结果表明侧支循环在冠状动脉闭塞期间对心肌灌注具有保护作用。有效的血管造影侧支循环可能预防静息时局部室壁运动异常，但似乎不能预防负荷诱导的灌注缺损。
