Iosseliani D G, Koval A N, Bhattacharya P K
Bakulev's Institute for Cardiovascular Surgery, Moscow, Russia.
Int J Card Imaging. 1994 Jun;10(2):155-9. doi: 10.1007/BF01137712.
The aim of this study was to investigate myocardial perfusion of the left ventricle during stress (exercise scintigraphy with thallium-201) in 25 patients having new-onset angina (NA) with single-vessel disease. In 14 cases (56%) the lumen of the vessel was obstructed by more than 75% and in 6 cases (24%) it was totally occluded. Angiographically visible collaterals to the occluded arteries from other vessels were present in all these cases. All of the patients studied had some form of myocardial perfusion disturbance. In 13 patients (52%) perfusion defects were limited to distribution within the obstructed artery; the other 9 patients (36%) had defects in the pool of the intact artery with or without defects in the pool of the obstructed artery. In the 4 patients (44.4%) having a totally occluded artery, perfusion defects were observed only in the pool of the intact artery supplying the collaterals, while in 5 patients (55.6%) perfusion defects were found both in the pool of the intact artery supplying the collaterals as well as in the obstructed vessel. We conclude that in patients with NA, stress dependent perfusion defects are present not only in the pool of the obstructed artery but also in the intact artery supplying the collaterals. This point to the possible presence of 'steal' syndrome in these patients.
本研究的目的是调查25例新发心绞痛（NA）伴单支血管病变患者在应激状态下（用铊-201进行运动闪烁扫描）左心室的心肌灌注情况。在14例（56%）患者中，血管腔阻塞超过75%，6例（24%）患者血管完全闭塞。所有这些病例中均可见到从其他血管向闭塞动脉发出的血管造影可见的侧支循环。所有研究患者均有某种形式的心肌灌注紊乱。13例（52%）患者的灌注缺损局限于阻塞动脉的供血区域内；另外9例（36%）患者在正常动脉供血区域有缺损，阻塞动脉供血区域有或无缺损。在4例（44.4%）动脉完全闭塞的患者中，仅在供应侧支循环的正常动脉供血区域观察到灌注缺损，而在5例（55.6%）患者中，在供应侧支循环的正常动脉供血区域以及阻塞血管中均发现灌注缺损。我们得出结论，在NA患者中，应激依赖性灌注缺损不仅存在于阻塞动脉供血区域，也存在于供应侧支循环的正常动脉中。这表明这些患者可能存在“窃血”综合征。
