Shaw D B, Linker N J, Heaver P A, Evans R
Cardiac Department, Royal Devon and Exeter Hospital.
Br Heart J. 1987 Dec;58(6):598-607. doi: 10.1136/hrt.58.6.598.
Postmortem angiography was used to examine the blood vessels supplying the sinoatrial node in 25 subjects with chronic sinoatrial disorder (group 1). The results were compared with similar studies in 54 subjects who died of heart block and in whom sinus node function was normal (group 2). Although no significant lesion obstructing the blood flow to the sinus node was seen in the majority of those in group 1, there were abnormalities in seven cases, with reduced filling of the sinus node artery in five. In group 2 the sinus node artery filled normally in all cases despite major disease of the parent vessel in three. The combination of contralateral coronary artery disease with extensive atrial anastomoses was actively sought because this arrangement might predispose to a steal phenomenon. Such conditions were fully met in three cases in group 1 and two cases in group 2, and were found to a lesser extent in a further two cases in group 1 and three in group 2. Although coronary artery disease was unlikely to be the principal cause of sinus node dysfunction in most of the cases studied it was relatively common and may have been a factor in about one third. Improved survival after myocardial infarction may increase the number of patients with chronic sinoatrial disorder of ischaemic origin.
对25例患有慢性窦房结功能障碍的受试者（第1组）进行尸检血管造影，以检查供应窦房结的血管。将结果与54例死于心脏传导阻滞且窦房结功能正常的受试者（第2组）的类似研究进行比较。尽管在第1组的大多数受试者中未发现明显阻碍窦房结血流的病变，但有7例存在异常，其中5例窦房结动脉充盈减少。在第2组中，尽管有3例患者的主干血管存在严重病变，但所有病例的窦房结动脉均正常充盈。积极寻找对侧冠状动脉疾病合并广泛心房吻合的情况，因为这种情况可能易引发窃血现象。第1组有3例、第2组有2例完全符合这些情况，第1组另有2例、第2组另有3例在较小程度上符合这些情况。尽管在所研究的大多数病例中，冠状动脉疾病不太可能是窦房结功能障碍的主要原因，但它相对常见，在约三分之一的病例中可能是一个因素。心肌梗死后生存率的提高可能会增加缺血性起源的慢性窦房结功能障碍患者的数量。
