Niermann F, Jehle J, Pölitz B, Schmiel F K, Spiller P
Z Kardiol. 1987 Feb;76(2):102-9.
The hemodynamic significance of coronary artery stenoses cannot be assessed by presently-used methods. Especially stenoses of small and moderate degree only reveal hemodynamic relevance during augmentation of coronary flow. It can be expected that the increase in flow is limited in a stenotic branch, compared with an unstenosed branch of the same vessel. The increase in coronary blood flow in two unstenosed branches of the same vessel, however, should be nearly identical. To prove this hypothesis, the relative increase in coronary flow was measured in two unstenosed branches of the left coronary artery by means of digital subtraction angiocardiography. Ten patients were examined before and after intravenous administration of 20 mg (on average 0.29 mg/kg body weight) dipyridamole. Dipyridamole resulted in an increase in the diameter of the left anterior descending branch (LAD) of 11% (p less than 0.005) and of the circumflex artery (RCx) of 13% (p less than 0.005). The increase in flow velocity during systole amounted to 49% in the LAD (p less than 0.001) and to 58% in the RCx (p less than 0.005); during diastole to 60% in the LAD (p less than 0.005) and 83% in the RCx (p less than 0.005). The increase in volume flow during systole amounted to 78% in the LAD (p less than 0.005) and to 89% in the RCx (p less than 0.005), during diastole to 84% in the LAD (p less than 0.005) and to 113% in the RCx (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
目前使用的方法无法评估冠状动脉狭窄的血流动力学意义。尤其是轻中度狭窄仅在冠状动脉血流增加时才显示出血流动力学相关性。可以预期,与同一血管的无狭窄分支相比,狭窄分支中的血流增加是有限的。然而,同一血管的两个无狭窄分支中的冠状动脉血流增加应该几乎相同。为了验证这一假设,通过数字减影血管造影术测量了左冠状动脉两个无狭窄分支中的冠状动脉血流相对增加情况。对10名患者在静脉注射20毫克(平均0.29毫克/千克体重)双嘧达莫前后进行了检查。双嘧达莫使左前降支(LAD)直径增加了11%(p<0.005),使回旋支(RCx)直径增加了13%(p<0.005)。收缩期LAD的血流速度增加了49%(p<0.001),RCx增加了58%(p<0.005);舒张期LAD增加了60%(p<0.005),RCx增加了83%(p<0.005)。收缩期LAD的容积流量增加了78%(p<0.005),RCx增加了89%(p<0.005),舒张期LAD增加了84%(p<0.005),RCx增加了113%(p<0.005)。(摘要截断于250字)