Zijlstra F, Reiber J C, Juilliere Y, Serruys P W
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1988 Jan 1;61(1):55-60. doi: 10.1016/0002-9149(88)91304-5.
Fifteen patients undergoing routine follow-up angiography 5 months after successful percutaneous transluminal coronary angioplasty (PTCA) without angina and with normal exercise thallium scintigraphy were selected for analysis. The coronary flow reserves of these patients were compared with those of 24 patients with angiographically normal coronary arteries to establish whether PTCA can restore to normal the coronary flow reserve of patients with chronic coronary artery disease. The quantitative cineangiographic changes and the concomitant alterations in coronary flow reserve as an immediate result of the PTCA and the subsequent changes 5 months later are described. Coronary flow reserve was measured with digital subtraction cineangiography. PTCA resulted in an increase in minimal obstruction area (mean +/- standard deviation) from 0.8 +/- 0.3 to 3.4 +/- 0.7 mm2 and in coronary flow reserve from 1.0 +/- 0.3 to 2.5 +/- 0.6. Five months later a further substantial and significant (p less than 0.05) late increase in obstruction area (3.8 +/- 0.9 mm2) and flow reserve (3.6 +/- 0.5) had occurred. In 11 of 15 patients coronary flow reserve was restored to normal. Changes in stenosis geometry are likely to be 1 of the major determinants of this late normalization of coronary flow reserve.
选择15例成功进行经皮腔内冠状动脉成形术（PTCA）后5个月接受常规随访血管造影的患者进行分析，这些患者无心绞痛症状，运动铊闪烁扫描结果正常。将这些患者的冠状动脉血流储备与24例冠状动脉造影正常的患者进行比较，以确定PTCA能否使慢性冠状动脉疾病患者的冠状动脉血流储备恢复正常。描述了PTCA即刻导致的定量电影血管造影变化及冠状动脉血流储备的相应改变，以及5个月后的后续变化。冠状动脉血流储备通过数字减法电影血管造影测量。PTCA使最小阻塞面积（均值±标准差）从0.8±0.3增加到3.4±0.7mm²，冠状动脉血流储备从1.0±0.3增加到2.5±0.6。5个月后，阻塞面积（3.8±0.9mm²）和血流储备（3.6±0.5）进一步显著增加（p＜0.05）。15例患者中有11例冠状动脉血流储备恢复正常。狭窄几何形状的改变可能是冠状动脉血流储备后期恢复正常的主要决定因素之一。
