Schulz W, Wolf P, Kaltenbach M, Kober G
Zentrum der Inneren Medizin, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main.
Z Kardiol. 1990 Sep;79(9):628-32.
The frequency of "eccentric" stenoses was determined in 676 coronary angiograms, which proved to be useful to classify stenoses according to their position (central, eccentric), as well as to the form of residual lumen (round, not round). The results for 616 stenoses which could be evaluated for both position and form were: 30% (183/616) centrally located with round residual lumen; 10% (60/616) centrally located with no round residual lumen; 41% (255/616) eccentrically located with round residual lumen; 19% (115/616) eccentrically located with no round residual lumen. These results are in agreement with previous autopsy findings. The location and form of coronary stenoses may have different meanings: the prevalent round form of residual lumina (71% of all evaluated stenoses) may characterize a normal growing of stenoses, while no round forms might indicate complications such as ruptures with hemorrhage within plaques. The prevalent eccentric location of residual lumina (63% of all evaluated stenoses) may reflect a tendency to dynamic coronary tone within the respective coronary stenosis. This assumption is supported by similar frequencies of dilatative or constrictive responses in patients with coronary artery disease. Individual prognoses, however, with respect to coronary tone or coronary reactions cannot be predicted from morphology.
在676例冠状动脉血管造影中确定了“偏心性”狭窄的发生率，结果表明，根据狭窄的位置（中央型、偏心型）以及残余管腔的形态（圆形、非圆形）对狭窄进行分类是有用的。对616例可同时评估位置和形态的狭窄的结果如下：30%（183/616）为中央型狭窄且残余管腔为圆形；10%（60/616）为中央型狭窄且残余管腔非圆形；41%（255/616）为偏心型狭窄且残余管腔为圆形；19%（115/616）为偏心型狭窄且残余管腔非圆形。这些结果与之前的尸检结果一致。冠状动脉狭窄的位置和形态可能具有不同的意义：残余管腔普遍呈圆形（在所有评估的狭窄中占71%）可能是狭窄正常进展的特征，而非圆形可能表明存在并发症，如斑块内出血破裂。残余管腔普遍呈偏心位置（在所有评估的狭窄中占63%）可能反映了相应冠状动脉狭窄内动态冠状动脉张力的趋势。冠心病患者中扩张或收缩反应的类似发生率支持了这一假设。然而，无法从形态学预测个体关于冠状动脉张力或冠状动脉反应的预后。
