Tousoulis D, Davies G, Crake T, Ohri S K, Rao P, Taylor K M
Cardiothoracic Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Ann Thorac Surg. 1994 Sep;58(3):857-63. doi: 10.1016/0003-4975(94)90767-6.
To investigate the effects of coronary artery disease progression on left ventricular function in patients who suffer angina early after coronary artery bypass grafting, we studied the progression of coronary stenoses, the occurrence of graft occlusions, and measured left ventricular ejection fraction (regional and global) in 34 consecutive patients who underwent repeat angiography 25.2 +/- 3.5 (standard error of the mean) months postoperatively, from a total population of 550 patients who underwent bypass grafting. Resting left ventricular function and stenosis severity were assessed using a computerized, quantitative analysis system. Coronary stenosis progression was defined as an increase in the percentage of the stenotic occlusion by 30% or more, any increase in lesion severity that resulted in total coronary artery occlusion, or the occurrence of a new stenosis that occluded the artery by 50% or more. Group 1 comprised 21 patients with all grafts patent and group 2 comprised 13 patients with one or more grafts occluded (20 of 34 grafts). Coronary artery disease progressed in all patients in group 1, and this involved 22 of 54 (41%) grafted vessels and 3 of 15 (20%) nongrafted vessels (p < 0.05). Coronary artery disease progressed in 11 patients in group 2, involving 15 of 32 (47%) grafted vessels and 1 of 6 (17%) nongrafted vessels (p < 0.01). An increased collateral circulation was observed in both groups. The left ventricular ejection fraction remained unchanged in both groups (group 1, 0.60 +/- 0.03 versus 0.62 +/- 0.03; group 2, 0.62 +/- 0.05 versus 0.62 +/- 0.04 before and after bypass, respectively; p = not significant) and there was no difference between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究冠状动脉搭桥术后早期发生心绞痛的患者中冠状动脉疾病进展对左心室功能的影响，我们在550例行搭桥手术的患者中，对34例术后25.2±3.5（均值标准误）个月接受再次血管造影的连续患者，研究了冠状动脉狭窄的进展、移植血管闭塞的发生情况，并测量了左心室射血分数（局部和整体）。使用计算机化定量分析系统评估静息左心室功能和狭窄严重程度。冠状动脉狭窄进展定义为狭窄闭塞百分比增加30%或更多、导致冠状动脉完全闭塞的病变严重程度的任何增加，或出现使动脉闭塞50%或更多的新狭窄。第1组包括21例所有移植血管通畅的患者，第2组包括13例有一根或多根移植血管闭塞的患者（34根移植血管中的20根）。第1组所有患者的冠状动脉疾病均有进展，累及54根移植血管中的22根（41%）和15根非移植血管中的3根（20%）（p<0.05）。第2组11例患者的冠状动脉疾病有进展，累及32根移植血管中的15根（47%）和6根非移植血管中的1根（17%）（p<0.01）。两组均观察到侧支循环增加。两组的左心室射血分数均保持不变（第1组，搭桥前后分别为0.60±0.03和0.62±0.03；第2组，分别为0.62±0.05和0.62±0.04；p无显著性差异），且两组之间无差异。（摘要截断于250字）
