Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
J Cardiovasc Med (Hagerstown). 2011 Oct;12(10):709-13. doi: 10.2459/JCM.0b013e328349187c.
Conduction disturbances are related to coronary artery lesions. However, the types of coronary artery lesions prevalent among patients having conduction disturbances are still uncertain.
To investigate the status of coronary artery lesions in 107 consecutive symptomatic patients admitted to the fourth affiliated hospital of Harbin Medical University between 2005 and 2009 to receive pacemaker implantation.
All of the patients previously underwent coronary angiography for detection of symptoms related to coronary artery disease. The coronary angiographic study included stenosis severity and classification of pathological anatomy. Eighty patients had obvious coronary artery lesions; therefore, 80 age-matched individuals with more than 50% coronary artery lesions but without conduction disturbance composed the control group. The differences in the status of coronary artery lesions were studied between the groups.
Third-degree atrioventricular block (AVB) was diagnosed in 51 patients (47.7%); 49 (45.8%) had sick sinus syndrome and 7 (6.5%) had Mobitz II, second-degree AVB. Individuals with type IV lesions accounted for 51.3% of the patients with coronary artery lesions, whereas those with type II lesions had the second highest prevalence (26.3%). Patients with type III and I lesions accounted for 15 and 7.5% of the cases, respectively. This distribution was significantly different from those in the control group in which the most prevalent types were type III and IV (46.8 and 31.6%, P < 0.05, respectively).
The prevalence of coronary lesion types was different for patients with conduction disturbance from those without it; both left anterior descending artery and right coronary artery appeared to be involved in patients with conduction disturbance.
传导障碍与冠状动脉病变有关。然而,患有传导障碍的患者中常见的冠状动脉病变类型仍不确定。
调查 2005 年至 2009 年期间哈尔滨医科大学第四附属医院连续 107 例因症状接受起搏器植入的患者的冠状动脉病变状况。
所有患者均接受冠状动脉造影检查,以检测与冠心病相关的症状。冠状动脉造影研究包括狭窄严重程度和病理学解剖分类。80 例患者有明显的冠状动脉病变;因此,80 名年龄匹配的患者有超过 50%的冠状动脉病变但无传导障碍组成对照组。研究了两组间冠状动脉病变状况的差异。
51 例患者(47.7%)诊断为三度房室传导阻滞(AVB);49 例(45.8%)有窦性心动过缓,7 例(6.5%)有莫氏 II 型,二度 AVB。有病变类型 IV 的患者占冠状动脉病变患者的 51.3%,而病变类型 II 的患者次之(26.3%)。病变类型 III 和 I 的患者分别占 15%和 7.5%。与对照组相比,这种分布差异显著,对照组中最常见的病变类型是 III 和 IV 型(分别为 46.8%和 31.6%,P<0.05)。
传导障碍患者的冠状动脉病变类型与无传导障碍患者不同;左前降支和右冠状动脉似乎都参与了传导障碍患者的病变。