Freudenberg H, Lichtlen P R
Z Kardiol. 1981 Dec;70(12):863-9.
In 384 stenotic coronary segments of extramural arteries (left main coronary artery, LAD, LCX, RCA) with degrees of obstruction greater than 50% (but less than 100%) when assessed histologically, the extent and incidence of the normal wall segment (NWS) analysed from the histological cross section were carefully evaluated. Incidence and extent of the NWS proved to be unexpectedly high: 45% of all obstructions showed a NWS of more than 25% and 74% a NWS of more than 8% of the total histological circumference of the coronary artery. Furthermore, 25% of all obstructions showed a NWS of more than 50% and 71% a NWS of more than 16% of the circumference of the residual lumen. The incidence of obstructions was highest in the LAD (41%) and lowest in the left main coronary artery (8%). In the three vessels of the left coronary artery (left main, LAD, LCX) excentric obstructions were seen more often than in the RCA. The results are discussed with regard to the pathogenesis esp. of unstable angina pectoris, but also to the pharmacological and mechanical dilatation of coronary obstructions.
在384个壁外动脉(左冠状动脉主干、左前降支、左旋支、右冠状动脉)的狭窄冠状动脉节段中,组织学评估显示阻塞程度大于50%(但小于100%),仔细评估了从组织学横截面分析的正常壁段(NWS)的范围和发生率。结果表明,NWS的发生率和范围出乎意料地高:在所有阻塞中,45%的阻塞显示NWS超过冠状动脉总组织学周长的25%,74%的阻塞显示NWS超过8%。此外,所有阻塞中有25%显示NWS超过残余管腔周长的50%,71%显示NWS超过16%。阻塞发生率在左前降支最高(41%),在左冠状动脉主干最低(8%)。在左冠状动脉的三支血管(左主干、左前降支、左旋支)中,偏心性阻塞比右冠状动脉更常见。本文就特别是不稳定型心绞痛的发病机制以及冠状动脉阻塞的药物和机械扩张对结果进行了讨论。