Kolibash A J, Goodenow J S, Bush C A, Tetalman M R, Lewis R P
Circulation. 1979 Jan;59(1):66-74. doi: 10.1161/01.cir.59.1.66.
Changes in myocardial perfusion and left ventricular function were evaluated pre- and post-operatively (3--6 months) in 14 patients with unstable angina who underwent coronary artery bypass surgery. Perfusion was studied with intracoronary and intragraft injections of radiolabeled macroaggregated albumin particles. Of 20 abnormal perfusion areas identified preoperatively, 13 demonstrated improved perfusion post-operatively. Segmental analysis of the left ventriculogram demonstrated improved wall motion in 29 abnormally contracting segments; 18 normalized. Areas which showed improvement of left ventricular perfusion were invariably associated with improvement of left ventricular wall motion. Five patients showed improvement in perfusion and contraction in areas of apparent old myocardial infarction. Thirteen of the 14 patients had significantly less angina whether or not there was evidence of improved perfusion. However, only those patients who demonstrated improved perfusion had a significant improvement in their treadmill exercise tolerance postoperatively. Thus, patients with unstable angina have perfusion defects which may be reversed as a result of saphenous vein graft surgery. Reversal of these perfusion abnormalities results in improved left ventricular performance and better exercise tolerance postoperatively.
对14例接受冠状动脉搭桥手术的不稳定型心绞痛患者在术前及术后（3 - 6个月）评估心肌灌注和左心室功能。通过冠状动脉内和移植血管内注射放射性标记的大聚合白蛋白颗粒来研究灌注情况。术前确定的20个灌注异常区域中，13个在术后显示灌注改善。左心室造影的节段分析显示，29个异常收缩节段的壁运动改善；18个恢复正常。左心室灌注改善的区域总是与左心室壁运动的改善相关。5例在明显陈旧性心肌梗死区域的灌注和收缩有改善。14例患者中有13例心绞痛明显减轻，无论是否有灌注改善的证据。然而，只有那些显示灌注改善的患者术后跑步机运动耐量有显著改善。因此，不稳定型心绞痛患者存在灌注缺陷，可因大隐静脉移植手术而逆转。这些灌注异常的逆转导致术后左心室功能改善和运动耐量提高。
