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经皮腔内血管成形术期间的左心室功能:一项血流动力学和血管造影研究。

Left ventricular function during transluminal angioplasty: a haemodynamic and angiographic study.

作者信息

Serruys P W, Wijns W, van den Brand M, Mey S, Slager C, Schuurbiers J C, Hugenholtz P G, Brower R W

出版信息

Acta Med Scand Suppl. 1985;694:197-206. doi: 10.1111/j.0954-6820.1985.tb08815.x.

Abstract

The response of left ventricular function, was studied in a series of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). From 4 to 6 balloon inflations procedures per patient were performed with an average duration per occlusion of 51 +/- 12 sec (mean +/- SD), total occlusion time 252 +/- 140 sec. Analysis of left ventricular (LV) haemodynamics showed that the relaxation parameters peak negative rate of change in pressure and the early time constant of relaxation responded earliest to acute coronary occlusion while other parameters such as peak pressure, LV end-diastolic pressure, and peak positive rate of change of pressure responded more gradually and suggested a progressive depression in myocardial mechanics during the entire procedure. LV angiogram available in 14 patients indicate an early onset of asynchronous relaxation concurrent with the early response in peak -dP/dt and the time constant of early relaxation. All haemodynamic parameters fully recovered within minutes after the end of PTCA. The results of this study indicate no permanent dysfunction to global or regional myocardial mechanics, after PTCA with 4 to 6 coronary occlusions each lasting 40 to 60 seconds.

摘要

在一系列接受经皮腔内冠状动脉成形术(PTCA)的患者中,研究了左心室功能的反应。每位患者进行4至6次球囊充盈操作,每次闭塞的平均持续时间为51±12秒(平均值±标准差),总闭塞时间为252±140秒。左心室(LV)血流动力学分析表明,压力的峰值负变化率和早期松弛时间常数等松弛参数对急性冠状动脉闭塞反应最早,而其他参数如峰值压力、左心室舒张末期压力和压力的峰值正变化率反应较为缓慢,表明在整个过程中心肌力学逐渐受到抑制。14例患者的左心室血管造影显示,早期出现异步松弛,与峰值-dP/dt和早期松弛时间常数的早期反应同时出现。PTCA结束后几分钟内,所有血流动力学参数均完全恢复。本研究结果表明,在每次持续40至60秒的4至6次冠状动脉闭塞的PTCA后,整体或局部心肌力学没有永久性功能障碍。

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