Piek J J, Koolen J J, Hoedemaker G, David G K, Visser C A, Dunning A J
Department of Cardiology, University of Amsterdam, The Netherlands.
Am J Cardiol. 1991 Jan 1;67(1):13-7. doi: 10.1016/0002-9149(91)90091-x.
To determine the factors that influence the presence of collateral vessels during coronary occlusion, we performed standardized contrast injection of the contralateral coronary artery in 58 consecutive patients, without previous myocardial infarction, undergoing percutaneous transluminal coronary angioplasty for 1-vessel disease (left anterior descending artery in 45, right coronary artery: in 10 and left circumflex artery in 3). The presence of collateral vessels during coronary occlusion, defined as partial or complete epicardial opacification by collateral vessels of the vessel dilated, was related to clinical, angiographic and electrocardiographic parameters. The angiographic appearance of collateral vessels during balloon inflation showed a weak, although statistically significant, correlation to the percent diameter stenosis before angioplasty (r = 0.28; p = 0.03) and the duration of angina (r = 0.37; p = 0.004). By combining lesion severity with the duration of angina, collateral vessels during coronary occlusion were particularly related to a lesion severity greater than or equal to 70% and duration of angina greater than or equal to 3 months (p less than 0.001). Furthermore, the presence of collateral vessels was associated with an absence of ST-segment shift (greater than or equal to 1 mm) during 1 minute of coronary occlusion (p less than 0.001).
为了确定冠状动脉闭塞期间影响侧支血管存在的因素，我们对58例连续的患者进行了对侧冠状动脉的标准化造影剂注射，这些患者既往无心肌梗死，因单支血管病变（45例为左前降支动脉，10例为右冠状动脉，3例为左旋支动脉）接受经皮腔内冠状动脉成形术。冠状动脉闭塞期间侧支血管的存在，定义为扩张血管的侧支血管使部分或完全的心外膜显影，与临床、血管造影和心电图参数相关。球囊扩张时侧支血管的血管造影表现与血管成形术前直径狭窄百分比（r = 0.28；p = 0.03）和心绞痛持续时间（r = 0.37；p = 0.004）呈弱相关，尽管具有统计学意义。通过将病变严重程度与心绞痛持续时间相结合，冠状动脉闭塞期间的侧支血管尤其与病变严重程度大于或等于70%和心绞痛持续时间大于或等于3个月相关（p小于0.001）。此外，冠状动脉闭塞1分钟期间侧支血管的存在与无ST段移位（大于或等于1mm）相关（p小于0.001）。
