Uchida Y, Nakamura F, Tomaru T, Miwa A, Morita T
Second Department of Internal Medicine, University of Tokyo, Japan.
Heart Vessels. 1995;10(2):106-10. doi: 10.1007/BF01744501.
It is not known whether the individual lesions that constitute tandem lesions of the coronary artery are developmentally or rheologically related. Luminal changes and their rheological significance were examined by percutaneous angioscopy in 44 tandem lesions of 21 patients with ischemic heart disease. Angioscopically, individual narrowing of angiographically documented tandem lesions appeared only as a tangentially expressed prominent portion of an atherosclerotic spiral fold. The directions of the fold were counterclockwise in the proximal to middle segments and clockwise in the distal segment of the right coronary artery, clockwise in the proximal to middle segments and counterclockwise in the distal segment of the left anterior descending artery, and counterclockwise in the proximal to middle segments of the left circumflex artery. The bloodstream always ran along the spiral folds in the tandem lesions. The results suggest that angiographically documented tandem coronary lesions are merely a tangential expression of atherosclerotic spiral folds and that they may act to prevent blood turbulence by generating a spiral laminal flow.
构成冠状动脉串联病变的各个病变在发育上或流变学上是否相关尚不清楚。通过经皮血管镜检查，对21例缺血性心脏病患者的44个串联病变的管腔变化及其流变学意义进行了研究。在血管镜下，血管造影记录的串联病变的单个狭窄仅表现为动脉粥样硬化螺旋褶切向表达的突出部分。在右冠状动脉近端至中段，褶的方向为逆时针，在远端为顺时针；在左前降支近端至中段为顺时针，在远端为逆时针；在左旋支近端至中段为逆时针。血流总是沿着串联病变中的螺旋褶流动。结果表明，血管造影记录的冠状动脉串联病变仅仅是动脉粥样硬化螺旋褶的切向表现，它们可能通过产生螺旋层流来防止血液湍流。
