Nishigami K, Ando M, Hayasaki K
Division of Cardiology, Saiseikai Kumamoto Hospital, School of Medicine, Kumamoto University, Japan.
Am Heart J. 1995 Aug;130(2):244-7. doi: 10.1016/0002-8703(95)90435-2.
We evaluated the effects of antecedent anginal episodes and coronary artery stenosis on left ventricular function during coronary occlusion and the role of collateral filling in 33 patients with angina pectoris who underwent angioplasty. Wall motion abnormalities were investigated by echocardiography and classified into hypokinesia and akinesia. Collateral filling during angioplasty was evaluated by using a second artery catheter. Akinesia was observed as follows: 24% of the patients had > 30 anginal episodes, 38% had 5 to 30, and 87% of the patients had < 5 (p < 0.01); 12% of patients had a lesion of 99%, 47% had a lesion of 90%, and 83% had a lesion of 75% (p < 0.05). Akinesia was observed in none of the patients with grade 3 collaterals, 57% with grade 2, and 67% with grade 1 or 0 (p < 0.01). These observations suggest that the patients with antecedent frequent anginal episodes and severe coronary stenosis have less left ventricular dysfunction during coronary occlusion. This finding may be the result of more extensive collateral development.
我们评估了33例接受血管成形术的心绞痛患者在冠状动脉闭塞期间，先前的心绞痛发作和冠状动脉狭窄对左心室功能的影响以及侧支循环充盈的作用。通过超声心动图研究室壁运动异常，并将其分为运动减弱和运动消失。血管成形术期间的侧支循环充盈通过使用第二根动脉导管进行评估。观察到运动消失情况如下：24%的患者有超过30次心绞痛发作，38%的患者有5至30次，87%的患者有少于5次（p<0.01）；12%的患者病变为99%，47%的患者病变为90%，83%的患者病变为75%（p<0.05）。在3级侧支循环的患者中未观察到运动消失，2级侧支循环的患者中有57%出现运动消失，1级或0级侧支循环的患者中有67%出现运动消失（p<0.01）。这些观察结果表明，先前有频繁心绞痛发作和严重冠状动脉狭窄的患者在冠状动脉闭塞期间左心室功能障碍较轻。这一发现可能是更广泛侧支循环发展的结果。
