Nitenberg A, Foult J M, Antony I, Blanchet F, Rahali M
Laboratoire d'Hémodynamique et d'Angiocardiographie, INSERM U.251, CHU Xavier Bichat, Paris, France.
J Am Coll Cardiol. 1988 Mar;11(3):478-86. doi: 10.1016/0735-1097(88)91520-3.
Left ventricular hypertrophy has been found to be associated with a reduction of coronary vascular reserve, which could be responsible for episodes of myocardial ischemia. To evaluate coronary flow and resistance reserve in patients with chronic aortic regurgitation, coronary sinus blood flow and coronary resistance were measured before and after an intravenous dipyridamole infusion (0.14 mg/kg per min X 4 min) in eight control subjects and eight patients with aortic regurgitation, exertional angina pectoris and normal coronary arteriograms. Coronary flow reserve, evaluated by the dipyridamole/basal coronary sinus blood flow ratio, and coronary resistance reserve, evaluated by the basal/dipyridamole coronary resistance ratio, were both significantly reduced in patients with aortic regurgitation (1.67 +/- 0.40 versus 4.03 +/- 0.52 in control subjects, p less than 0.001 and 1.71 +/- 0.50 versus 4.38 +/- 0.88 in control subjects, p less than 0.001, respectively). In patients with aortic regurgitation, basal coronary sinus blood flow was higher than in control subjects (276 +/- 81 versus 105 +/- 24 ml/min, respectively, p less than 0.001) and basal coronary resistance was lower (0.31 +/- 0.13 versus 0.95 +/- 0.17 mm Hg/ml per min, respectively, p less than 0.001), but coronary blood flow and resistance after dipyridamole were not significantly different in the two groups (461 +/- 159 versus 418 +/- 98 ml/min in control subjects, 0.19 +/- 0.11 versus 0.22 +/- 0.04 mm Hg/ml per min in control subjects, respectively). These data demonstrate that coronary reserve is severely reduced in patients with chronic aortic regurgitation and exertional angina.(ABSTRACT TRUNCATED AT 250 WORDS)
左心室肥厚已被发现与冠状动脉储备的降低有关，这可能是心肌缺血发作的原因。为了评估慢性主动脉瓣关闭不全患者的冠状动脉血流和阻力储备，对8名对照受试者和8名患有主动脉瓣关闭不全、劳力性心绞痛且冠状动脉造影正常的患者，在静脉输注双嘧达莫（0.14 mg/kg每分钟×4分钟）前后测量冠状窦血流量和冠状动脉阻力。通过双嘧达莫/基础冠状窦血流量比值评估的冠状动脉血流储备和通过基础/双嘧达莫冠状动脉阻力比值评估的冠状动脉阻力储备，在主动脉瓣关闭不全患者中均显著降低（分别为1.67±0.40，对照受试者为4.03±0.52，p＜0.001；1.71±0.50，对照受试者为4.38±0.88，p＜0.001）。在主动脉瓣关闭不全患者中，基础冠状窦血流量高于对照受试者（分别为276±81与105±24 ml/分钟，p＜0.001），基础冠状动脉阻力较低（分别为0.31±0.13与0.95±0.17 mmHg/ml每分钟，p＜0.001），但两组在双嘧达莫后的冠状动脉血流和阻力无显著差异（对照受试者分别为461±159与418±98 ml/分钟，0.19±0.11与0.22±0.04 mmHg/ml每分钟）。这些数据表明，慢性主动脉瓣关闭不全和劳力性心绞痛患者的冠状动脉储备严重降低。（摘要截短于250字）
