de Feyter P J, Suryapranata H, Serruys P W, Beatt K, van den Brand M, Hugenholtz P G
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1987 Nov 1;60(13):993-7. doi: 10.1016/0002-9149(87)90339-0.
Sixty-eight patients (58 men, 10 women, mean age 56.3 years, range 31 to 72) with unstable angina pectoris, either initially stabilized with or refractory to optimal pharmacologic treatment, were studied to determine whether regional dysfunction due to stunning of the myocardium caused by attacks of chest pain at rest could be improved with percutaneous transluminal coronary angioplasty (PTCA). Patients were included in the study if they had successful 1-vessel PTCA, no angiographic restenosis, no reocclusion or late myocardial infarction and 2 serial left ventriculograms of sufficient quality to allow automated contour analysis before and after PTCA. Global ejection fraction increased significantly (from 56% to 60%, p less than 0.05) only after successful dilatation of a stenosis of the left anterior descending coronary artery. Analysis of regional wall displacement showed significant improvement of regional wall motion in the areas supplied by the dilated vessel of either the left anterior descending, the left circumflex or the right coronary artery. Thus, regional myocardial dysfunction due to stunning of the myocardium in patients with unstable angina improves after successful PTCA.
68例不稳定型心绞痛患者（58例男性，10例女性，平均年龄56.3岁，范围31至72岁），这些患者最初经最佳药物治疗后病情稳定或对其耐药，研究目的是确定经皮腔内冠状动脉成形术（PTCA）能否改善因静息性胸痛发作导致心肌顿抑引起的局部功能障碍。如果患者成功进行了单支血管PTCA、无血管造影再狭窄、无再闭塞或晚期心肌梗死，并且有2次质量足以进行PTCA前后自动轮廓分析的连续左心室造影，则纳入研究。仅在左前降支冠状动脉狭窄成功扩张后，整体射血分数才显著增加（从56%增至60%，p<0.05）。局部壁位移分析显示，左前降支、左旋支或右冠状动脉扩张血管所供血区域的局部壁运动有显著改善。因此，不稳定型心绞痛患者因心肌顿抑导致的局部心肌功能障碍在PTCA成功后会得到改善。
