Feldman R L, Conti C R, Pepine C J
J Am Coll Cardiol. 1983 Jul;2(1):1-10. doi: 10.1016/s0735-1097(83)80370-2.
Coronary hemodynamic responses to transient coronary artery occlusion in 21 patients were investigated by using regional coronary venous thermodilution to measure regional coronary venous flows. Transient coronary artery occlusion was produced by coronary artery spasm (13 patients) or balloon inflation during coronary angioplasty (8 patients). The left anterior descending coronary artery was transiently occluded in 12 patients, the right coronary artery in 8 patients and the left circumflex artery in 1 patient. During transient coronary occlusion, regional venous flow decreased in 20 of the 21 patients (79 +/- 31 to 53 +/- 29 ml/min, mean +/- standard deviation [SD]; probability [p] less than 0.05) corresponding to the left ventricular region perfused by the occluded artery. Regional coronary resistance increased in all 21 of these regions (1.42 +/- 0.75 to 2.26 +/- 1.45 mm Hg/ml per min, p less than 0.05). Simultaneously measured blood flow and resistance in the left ventricular region supplied by the nonoccluded arteries did not change significantly (62 +/- 27 to 64 +/- 29 ml/min and 1.85 +/- 0.93 to 1.81 +/- 0.98 mm Hg/ml per min, respectively). Coronary hemodynamic changes were similar during transient coronary occlusion, whether produced by coronary spasm or by balloon inflation. However, the presence of angina, reversible electrocardiographic abnormalities and an increase of the left ventricular filling pressure were more common during coronary spasm (p less than 0.05 for all). Regional coronary hemodynamic changes during transient occlusion of the anterior descending, circumflex or right coronary artery were similar. These data show that coronary occlusion decreases regional left ventricular flow in the region perfused by the affected artery. The method of coronary occlusion or the coronary artery affected during occlusion did not seem to elicit different responses.
通过使用区域冠状静脉热稀释法测量区域冠状静脉血流，对21例患者冠状动脉对短暂性冠状动脉闭塞的血流动力学反应进行了研究。短暂性冠状动脉闭塞是由冠状动脉痉挛（13例患者）或冠状动脉血管成形术期间球囊充盈（8例患者）引起的。12例患者的左前降支冠状动脉被短暂闭塞，8例患者的右冠状动脉被短暂闭塞，1例患者的左旋支冠状动脉被短暂闭塞。在短暂性冠状动脉闭塞期间，21例患者中有20例（79±31至53±29毫升/分钟，平均值±标准差[SD]；概率[p]小于0.05）对应于由闭塞动脉灌注的左心室区域的区域静脉血流减少。所有这21个区域的区域冠状动脉阻力均增加（1.42±0.75至2.26±1.45毫米汞柱/毫升每分钟，p小于0.05）。由未闭塞动脉供应的左心室区域同时测量的血流和阻力没有显著变化（分别为62±27至64±29毫升/分钟和1.85±0.93至1.81±0.98毫米汞柱/毫升每分钟）。无论是由冠状动脉痉挛还是球囊充盈引起的短暂性冠状动脉闭塞期间，冠状动脉血流动力学变化相似。然而，在冠状动脉痉挛期间，心绞痛、可逆性心电图异常和左心室充盈压升高更为常见（所有p均小于0.05）。前降支、左旋支或右冠状动脉短暂闭塞期间的区域冠状动脉血流动力学变化相似。这些数据表明，冠状动脉闭塞会降低受影响动脉灌注区域的左心室局部血流。冠状动脉闭塞的方法或闭塞期间受影响的冠状动脉似乎并未引发不同的反应。
