Feldman R L, Pepine C J
Am J Cardiol. 1984 May 1;53(9):1233-8. doi: 10.1016/0002-9149(84)90070-5.
The physiologic importance of coronary collateral vessels was investigated in 19 men undergoing transient proximal occlusion of the left anterior descending (LAD) branch without sedative medication. No vasodilators were given before LAD balloon occlusion. Six men had angiographic filling of the LAD via coronary collateral vessels (Group 1) and 13 did not (Group 2). Aortic, distal coronary and left ventricular (LV) filling pressures and great cardiac vein blood flow (thermodilution) were recorded continuously during occlusion. During LAD occlusion, clinical and electrocardiographic evidence for transient myocardial ischemia occurred more often in patients in Group 2 than in Group 1, but the difference was not statistically significant. Heart rate and aortic and distal coronary pressures were similar in Groups 1 and 2. LV filling pressure was 3 mm Hg higher in Group 2 patients (p less than 0.05). The aortic to distal coronary pressure difference and the distal coronary to LV filling pressure difference were also similar in Groups 1 and 2. However, residual great cardiac vein flow was 55% higher (p less than 0.05) and the calculated coronary collateral resistance index was 45% lower in patients in Group 2 compared with those in Group 1 (p less than 0.01). Coupling of regional coronary venous blood flow estimates to pressure measurements routinely made during angioplasty is a new technique that allows evaluation of determinants of coronary collateral function in conscious humans.(ABSTRACT TRUNCATED AT 250 WORDS)
在19名未使用镇静药物的男性中，研究了冠状动脉侧支血管的生理重要性。在左前降支（LAD）近端进行短暂闭塞时，未给予血管扩张剂。6名男性通过冠状动脉侧支血管实现了LAD的血管造影剂充盈（第1组），13名男性未实现（第2组）。在闭塞期间持续记录主动脉、冠状动脉远端和左心室（LV）充盈压力以及大心脏静脉血流量（热稀释法）。在LAD闭塞期间，第2组患者出现短暂性心肌缺血的临床和心电图证据比第1组更常见，但差异无统计学意义。第1组和第2组的心率、主动脉和冠状动脉远端压力相似。第2组患者的LV充盈压力高3 mmHg（p<0.05）。第1组和第2组的主动脉至冠状动脉远端压力差以及冠状动脉远端至LV充盈压力差也相似。然而，与第1组患者相比，第2组患者的大心脏静脉残余血流量高55%（p<0.05），计算得出的冠状动脉侧支阻力指数低45%（p<0.01）。将局部冠状动脉静脉血流量估计值与血管成形术期间常规进行的压力测量相结合是一种新技术，可用于评估清醒人体冠状动脉侧支功能的决定因素。（摘要截短至250字）
