Folts J D, Rowe G G, Kahn D R, Young W P
Am Heart J. 1979 Feb;97(2):211-5. doi: 10.1016/0002-8703(79)90358-2.
We have shown previously that acute aortic insufficiency in chronically instrumented dogs reverses the normally high ratio of diastolic to systolic coronary blood flow. Phasic blood flow in the dominant right coronary artery was measured directly with an electromagnetic flow meter during surgery in eight patients with severe aortic insufficiency before and after relacement of the aortic valve. Before the insufficiency was eliminated, right coronary flow average 116 +/- 37 ml./minute and the diastolic to systolic flow ratio was 0.88 +/- 17. Mean arterial blood pressure averaged 106 +/- 17 mm. Hg, heart rate 84 +/- 19 beats/minute, and mean diastolic pressure averaged 67 +/- 10 mm. Hg. After the aortic valve was replaced with an average heart rate of 90 +/- 15 and mean blood pressure of 103 +/- 13 mm. Hg, the average right coronary blood flow increased to 180 +/- 40 ml./minute with a D/S ratio of 2.18 +/- 0.8. In all cases the right coronary blood flow increased after the aortic insufficiency was eliminated surgically. Right coronary flow probably increased because of the improved diastolic perfusion pressure and the change from predominantly systolic to diastolic coronary flow.
我们之前已经表明，在长期植入仪器的犬类中，急性主动脉瓣关闭不全可逆转正常情况下较高的舒张期与收缩期冠状动脉血流比值。在八名严重主动脉瓣关闭不全患者进行主动脉瓣置换手术前后，术中使用电磁流量计直接测量了优势右冠状动脉的相位血流。在消除关闭不全之前，右冠状动脉血流量平均为116±37毫升/分钟，舒张期与收缩期血流比值为0.88±0.17。平均动脉血压平均为106±17毫米汞柱，心率84±19次/分钟，平均舒张压平均为67±10毫米汞柱。在用平均心率为90±15、平均血压为103±13毫米汞柱的人工瓣膜置换主动脉瓣后，右冠状动脉平均血流量增加到180±40毫升/分钟，舒张期与收缩期血流比值为2.18±0.8。在所有病例中，手术消除主动脉瓣关闭不全后，右冠状动脉血流量均增加。右冠状动脉血流量增加可能是由于舒张期灌注压力改善以及冠状动脉血流从主要为收缩期转变为舒张期。
