Feldman R L, Joyal M, Conti C R, Pepine C J
Am J Cardiol. 1984 Nov 1;54(8):958-63. doi: 10.1016/s0002-9149(84)80125-3.
Coronary collateral function was evaluated in 21 conscious, unsedated patients by measuring aortic and distal coronary pressures and great cardiac vein flow during transient (1 minute) balloon occlusion of the anterior descending artery in the course of coronary angioplasty. Measurements were made before and during administration of intravenous nitroglycerin (NTG). Clinical, electrocardiographic and hemodynamic events of transient myocardial ischemia occurred in 10 patients before and 6 patients during NTG administration (p = 0.11). The NTG infusion consistently decreased pressure determinants of myocardial oxygen demand without increasing heart rate. NTG also decreased a calculated coronary collateral resistance index in 13 patients. Responsiveness to NTG did not appear to depend on the presence or absence of collateral vessels detected by angiography or on any other angiographic variable assessed. Measurement of coronary collateral function during coronary angioplasty is a new technique with the potential to assess the ability of interventions to prevent transient myocardial ischemia and improve myocardial perfusion during acute coronary occlusion in humans.
在21例清醒、未使用镇静剂的患者中，于冠状动脉成形术过程中，通过在前降支短暂（1分钟）球囊闭塞期间测量主动脉和冠状动脉远端压力以及冠状大静脉血流，对冠状动脉侧支循环功能进行评估。在静脉注射硝酸甘油（NTG）之前和期间进行测量。10例患者在NTG给药前、6例患者在NTG给药期间发生了短暂性心肌缺血的临床、心电图和血流动力学事件（p = 0.11）。NTG输注持续降低心肌需氧量的压力决定因素，而不增加心率。NTG还降低了13例患者计算得出的冠状动脉侧支循环阻力指数。对NTG的反应性似乎不取决于血管造影检测到的侧支血管的有无或评估的任何其他血管造影变量。冠状动脉成形术期间冠状动脉侧支循环功能的测量是一种新技术，有可能评估干预措施预防人类急性冠状动脉闭塞期间短暂性心肌缺血和改善心肌灌注的能力。
