Iskandrian A S, Hakki A H, Nestico P F, DePace N L, Goel I P, Kane S
Int J Cardiol. 1984 Oct;6(4):537-45. doi: 10.1016/0167-5273(84)90334-6.
To assess the effects of residual coronary artery disease (non-revascularized coronary vessels) after coronary artery bypass grafting on symptoms and exercise left ventricular function, we categorized 77 patients into 3 groups according to the extent of residual coronary artery disease: group I (n = 17) had no residual coronary artery disease (residual score = 0); group II (n = 30) had light residual coronary artery disease (score of 1 to 9, mean 4.7); and group III (n = 30) had moderate residual coronary artery disease (score greater than or equal to 10, mean 23). Sixty patients were asymptomatic after coronary artery bypass grafting (14 in group I, 24 in group II, and 22 in group III), but the remaining patients had occasional angina pectoris. The resting left ventricular ejection fraction was significantly higher in group I than in the remaining 2 groups (56 +/- 18% in group I, 47 +/- 19% in group II, and 43 +/- 16% in group III, P less than 0.05). The exercise left ventricular ejection fraction was also significantly higher in group I (61 +/- 16% in group I, 51 +/- 18% in group II and 45 +/- 18% in group III, P less than 0.01). The ejection fraction response to exercise was abnormal in 5 patients in group I, 15 patients in group II, and 19 patients in group III. Thus, coronary artery bypass grafting results in symptomatic improvement, even in patients with residual coronary artery disease. The presence of residual coronary artery disease, however, may be a determinant of exercise left ventricular function in these patients.
为了评估冠状动脉旁路移植术后残余冠状动脉疾病（未行血运重建的冠状动脉血管）对症状及运动时左心室功能的影响，我们根据残余冠状动脉疾病的程度将77例患者分为3组：I组（n = 17）无残余冠状动脉疾病（残余评分为0）；II组（n = 30）有轻度残余冠状动脉疾病（评分为1至9，平均4.7）；III组（n = 30）有中度残余冠状动脉疾病（评分大于或等于10，平均23）。60例患者在冠状动脉旁路移植术后无症状（I组14例，II组24例，III组22例），但其余患者偶尔有心绞痛。I组静息左心室射血分数显著高于其余2组（I组为56±18%，II组为47±19%，III组为43±16%，P<0.05）。I组运动时左心室射血分数也显著更高（I组为61±16%，II组为51±18%，III组为45±18%，P<0.01）。I组有5例患者、II组有15例患者、III组有19例患者运动时射血分数反应异常。因此，冠状动脉旁路移植术即使对有残余冠状动脉疾病的患者也能改善症状。然而，残余冠状动脉疾病的存在可能是这些患者运动时左心室功能的一个决定因素。
