Kober G, Kuck H, Grossmann R, Kaltenbach M
Z Kardiol. 1981 Feb;70(2):81-7.
The significance of collaterals for left ventricular function at rest was studied on the basis of 345 consecutive angiographies of patients with coronary heart disease. According to the severity of coronary stenosis, patients were assigned to groups with one-, two-, and three-vessel disease. Subgroups were formed based on the extent of narrowing in percent. All angiograms were examined for the presence and absence of collaterals. The significance of the collaterals in evidence was quantified in terms of a collateral score. To assess left ventricular function, global (left ventricular enddiastolic pressure, left ventricular enddiastolic volume, left ventricular ejection fraction) and regional (percentage hemiaxis shortening) parameters were employed. Within the groups with the same degree of coronary stenosis, no differences in left ventricular function were observed even when regrouping was carried out according to the presence or absence of collaterals. The collateral score, however, suggested that left ventricular function was better in patients with good collaterals than in those with poor collaterals. Regional parameters of left ventricular function underscore the protective effect of collaterals for left ventricular function at rest particularly clearly. Global parameters of left ventricular function do not demonstrate this relationship quite as decisively, since regional disturbances of contractile function may be compensated for by hypercontraction of other wall areas.
基于对345例冠心病患者连续进行的血管造影，研究了侧支循环对静息状态下左心室功能的意义。根据冠状动脉狭窄的严重程度，将患者分为单支、双支和三支血管病变组。再根据狭窄程度的百分比进一步划分亚组。所有血管造影片均检查有无侧支循环。根据侧支循环评分对所发现的侧支循环的意义进行量化。为评估左心室功能，采用了整体参数（左心室舒张末期压力、左心室舒张末期容积、左心室射血分数）和局部参数（半心轴缩短百分比）。在冠状动脉狭窄程度相同的组内，即使根据有无侧支循环重新分组，左心室功能也未观察到差异。然而，侧支循环评分表明，侧支循环良好的患者左心室功能优于侧支循环不良的患者。左心室功能的局部参数尤其清楚地显示了侧支循环对静息状态下左心室功能的保护作用。左心室功能的整体参数并未如此明确地显示这种关系，因为收缩功能的局部紊乱可能会被其他壁区域的过度收缩所代偿。
