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[左冠状动脉主干狭窄。冠状动脉造影及血流动力学相关性研究。附34例报告]

[Stenosis of the trunk of the left coronary artery. Contribution of coronary arteriography and hemodynamic correlations. Apropos of 34 cases].

作者信息

Bernadet P, Fauvel J M, Donzeau J P, Labatut A, Bounhoure J P, Calazel P

出版信息

Arch Mal Coeur Vaiss. 1977 Nov;70(11):1121-8.

PMID:414668
Abstract

From a study of 34 cases, the authors have tried to define the characteristic features of this very specialised type of coronary artery disease. From the clinical standpoint, if the common combination of uncontrolled angina and a past history of myocardial infarction are taken as representative, the basal ECG can in no way differentiate the diagnosis; on the other hand tests on the bicycle ergometer appear to have a good indicative value. Coronary arteriography shows the sharply isolated character of the stenosis of the trunk which is part of the picture of diffuse coronary disease, and the frequency (2 cases out of 3) of total coronary occlusion. The haemodynamic findings are even more variable and unpredictable, and bear no relationship to the degree of trunk stenosis, to the index of the lesion, and to the number of occlusions. However, joint analysis of the index of the lesion and of the degree to which the coronary circulation is compensated or de-compensated allows a better interpretation of the haemodynamic picture.

摘要

通过对34例病例的研究,作者试图明确这种非常特殊类型的冠状动脉疾病的特征。从临床角度来看,如果将未控制的心绞痛与既往心肌梗死病史的常见组合作为代表,基础心电图根本无法区分诊断;另一方面,自行车测力计测试似乎具有良好的指示价值。冠状动脉造影显示,弥漫性冠状动脉疾病的一部分表现为冠状动脉主干狭窄呈明显孤立性,且冠状动脉完全闭塞的发生率(3例中有2例)。血流动力学结果变化更大且不可预测,与主干狭窄程度、病变指数和闭塞数量无关。然而,对病变指数以及冠状动脉循环代偿或失代偿程度进行联合分析,有助于更好地解读血流动力学情况。

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