Popma J J, Dehmer G J, Eichhorn E J
Cardiac Catheterization Laboratory, Dallas Veterans Administration Medical Center, Texas.
Int J Card Imaging. 1990;6(1):31-8. doi: 10.1007/BF01798430.
Coronary flow reserve (CFR) improves in most patients immediately following coronary angioplasty (PTCA). The degree of improvement, however, may be variable and its predictive value for a favorable long-term angiographic result is unknown. To evaluate these issues, we used digital subtraction angiography to measure CFR in 15 patients before and immediately after PTCA. Minimum coronary diameter improved and percent diameter stenosis was reduced immediately following PTCA (from 0.75 +/- 0.35 mm to 2.19 +/- 0.56 mm, and from 74 +/- 12% to 27 +/- 15%, respectively; p less than 0.001). While CFR improved in patients immediately following PTCA (from 1.49 +/- 0.75 to 2.68 +/- 1.73; p less than 0.05), a substantial variability in CFR measurements (range 0.80 to 8.33) was present. At repeat arteriography 2.9 +/- 0.6 months later, 4 patients demonstrated restenosis. Compared with the 11 patients without restenosis, those with restenosis had similar coronary dimensions and CFRs immediately following PTCA. We conclude that coronary flow reserve, determined by digital subtraction angiography, improves in most patients immediately after PTCA but the degree of improvement is variable. Its ability to predict long-term angiographic outcome remains uncertain.
大多数患者在冠状动脉血管成形术（PTCA）后即刻冠状动脉血流储备（CFR）会改善。然而，改善程度可能存在差异，其对长期血管造影良好结果的预测价值尚不清楚。为评估这些问题，我们采用数字减影血管造影术测量了15例患者PTCA前后的CFR。PTCA后即刻最小冠状动脉直径增加，直径狭窄百分比降低（分别从0.75±0.35mm增至2.19±0.56mm，从74±12%降至27±15%；p<0.001）。虽然患者在PTCA后即刻CFR有所改善（从1.49±0.75增至2.68±1.73；p<0.05），但CFR测量值存在很大差异（范围为0.80至8.33）。在2.9±0.6个月后的再次血管造影检查中，4例患者出现再狭窄。与11例无再狭窄的患者相比，有再狭窄的患者在PTCA后即刻冠状动脉尺寸和CFR相似。我们得出结论，通过数字减影血管造影术测定的冠状动脉血流储备在大多数患者PTCA后即刻会改善，但改善程度存在差异。其预测长期血管造影结果的能力仍不确定。
