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[不稳定型心绞痛且血管造影证实有侧支循环患者的左心室舒张指标]

[Indices of left ventricular diastole in patients with unstable angina and angiographically documented collateral circulation].

作者信息

Witkowski A

出版信息

Kardiol Pol. 1989;32(1):19-26.

PMID:2811022
Abstract

23 patients (20 males, 3 females) aged 26-62 (mean 45.9 +/- 9.9) with unstable angina underwent the study to evaluate the effect of collateral circulation vessels (CCV) on left ventricular diastole. There was no evidence of myocardial infarction in the past and ejection fraction was normal (EF greater than 60%). At least one branch of left coronary artery was significantly stenosed (more than 75% of a vessel lumen). Patients were divided into two groups: group I -- with CCV, group II -- without CCV. Obtained data were compared between these groups and with the control group (K) consisted of 10 persons. CCV were only observed if a coronary artery was occluded or subtotally stenosed. When a coronary artery was occluded, CCV could prevent myocardial infarction. Time constant (T) prolongation (43.6 +/- 10.8 vs 32 58 +/- 7.9 ms, p less than 0.05 for groups I and K and 49.31 +/- 18.8 vs 32.58 +/- 7.9 ms, p less than 0.02 for groups II and K) testifies to relaxation slowing down in patients with unstable angina, which indicates left ventricular myocardial ischemia. Lack of CCV influence on time constant T (43.6 +/- 10.8 vs 49.31 +/- 18.8 ms, p less than 0.5) as well as remaining left ventricular diastolic parameters (EDVI, EDP) seems that CCV were an insufficient source of a blood flow to myocardium supplied by a stenosed artery.

摘要

23例(20例男性,3例女性)年龄在26 - 62岁(平均45.9±9.9岁)的不稳定型心绞痛患者参与了本研究,以评估侧支循环血管(CCV)对左心室舒张功能的影响。既往无心肌梗死证据,射血分数正常(EF大于60%)。左冠状动脉至少有一个分支明显狭窄(血管腔狭窄超过75%)。患者分为两组:I组——有CCV,II组——无CCV。将这些组之间以及与由10人组成的对照组(K)获得的数据进行比较。仅在冠状动脉闭塞或次全狭窄时观察到CCV。当冠状动脉闭塞时,CCV可预防心肌梗死。时间常数(T)延长(I组和K组为43.6±10.8 vs 32.58±7.9毫秒,p<0.05;II组和K组为49.31±18.8 vs 32.58±7.9毫秒,p<0.02)证明不稳定型心绞痛患者舒张减慢,这表明左心室心肌缺血。CCV对时间常数T(43.6±10.8 vs 49.31±18.8毫秒,p<0.5)以及其余左心室舒张参数(EDVI、EDP)缺乏影响,似乎表明CCV是狭窄动脉供血心肌血流的不足来源。

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