Aubry P, Assayag P, Haddad A, Akesbi A, Brochet E, Guerot C, Valere P E
Service de cardiologie, CHU Beaujon, Clichy.
Arch Mal Coeur Vaiss. 1988 Oct;81(10):1175-80.
Correlations between left ventricular segmental kinetics and collateral circulation patterns were studied in 292 patients with coronary disease (182 women, 274 men: mean age 54 years). Left ventricular segmental kinetics were analyzed qualitatively by angiography (10 segments were individualized on RAO and LAO projections) and rated as normal, hypokinetic, akinetic or aneurysmal. The type of collateral circulation observed (contralateral, homocoronary and homolateral) and the number of collateral vessels were recorded. Collateral circulation was present in 49 p. 100 of the patients and in 29 p. 100 of the 587 pathological arteries (i.e. more than 50 p. 100 stenosis) identified. 89 p. 100 of the occluded arteries were revascularized by collateral circulation, the latter being effected by 213 collateral vessels (mean: 1.41 +/- 0.36 vessel per occluded artery). Collateral circulation through 1, 2 or 3 collateral vessels was noted in 62 p. 100, 35 p. 100 and 3 p. 100 respectively of the cases. Collateral circulation was contralateral in 51 p. 100, homocoronary in 33 p. 100 and homolateral in 16 p. 100 of the cases. Normal or hypokinetic segments in the territory of an occluded artery were more frequent in the presence (43 p. 100) than in the absence (31 p. 100) of collateral circulation, but the difference was not significant. They were also more frequent in three-vessel patients (59 p. 100) than in one-vessel (21 p. 100; p less than 0.01) or two-vessel (37 p. 100; p less than 0.05) patients in the presence of collateral circulation.(ABSTRACT TRUNCATED AT 250 WORDS)
对292例冠心病患者(182例女性,274例男性,平均年龄54岁)进行了左心室节段动力学与侧支循环模式之间相关性的研究。通过血管造影术对左心室节段动力学进行定性分析(在右前斜位和左前斜位投照下区分出10个节段),并将其评定为正常、运动减弱、运动不能或室壁瘤。记录观察到的侧支循环类型(对侧、同冠状动脉和同侧)以及侧支血管数量。49%的患者存在侧支循环,在587条病理性动脉(即狭窄超过50%)中有29%存在侧支循环。89%的闭塞动脉通过侧支循环实现了血管再通,侧支循环由213条侧支血管完成(平均每条闭塞动脉有1.41±0.36条血管)。分别有62%、35%和3%的病例中观察到通过1条、2条或3条侧支血管的侧支循环。51%的病例侧支循环为对侧,33%为同冠状动脉,16%为同侧。在存在侧支循环的情况下,闭塞动脉供血区域内的正常或运动减弱节段比不存在侧支循环时更常见(分别为43%和31%),但差异无统计学意义。在存在侧支循环的情况下,三支血管病变患者中这些节段也比单支血管病变患者(21%;P<0.01)或双支血管病变患者(37%;P<0.05)更常见。(摘要截短至250字)