Chen D, Lin J, Chen J
Department of Medicine, First Affiliated Hospital of Fujian Medical College, Fuzhou.
Chin Med Sci J. 1995 Sep;10(3):151-7.
Coronary blood flow reserve (CFR) was assessed by transesophageal Doppler echocardiography in normal subjects (group A, n = 20), hypertensive non-left ventricular hypertrophy (non-LVH) patients (group B, n = 22), hypertensive patients with LVH (group C, n = 32) and coronary heart disease patients (group D, n = 33) with the volume sample placed at the bifurcation of the left main and left descending coronary artery. Coronary blood flow velocity (CBFV) was evaluated at rest, 2 minutes after dipyridamole (0.56 mg/kg, i.v.), and 2 minutes after aminophylline i.v. The ratio of dipyridamole to rest maximal diastolic velocity (D/R PDV) was considered the index of coronary blood flow reserve. It was found that D/R PDV was significantly less in groups C and D compared with that in groups A and B(D/R PDV, 1.84 +/- 0.57, 1.57 +/- 0.41 versus 2.59 +/- 0.70 and 2.22 +/- 0.58, respectively), with no difference in D/R PDV between groups C and D. Twenty-four out of 32 patients in group C with D/R PDV were less than 2.0 compared to 29 out of 33 patients in group D (P > 0.05). Significant negative correlation was found between D/R PDV, D/R PSV and interseptal thickness, left ventricular mass index in hypertensive patients. These data show that impaired CFR in hypertensive patients with LVH is comparable to that in patients with coronary heart disease.
采用经食管多普勒超声心动图，将容积样本置于左主干和左冠状动脉前降支分叉处，对正常受试者（A组，n = 20）、高血压非左心室肥厚（非LVH）患者（B组，n = 22）、高血压左心室肥厚患者（C组，n = 32）和冠心病患者（D组，n = 33）进行冠状动脉血流储备（CFR）评估。分别于静息状态、静脉注射双嘧达莫（0.56 mg/kg）2分钟后及静脉注射氨茶碱2分钟后评估冠状动脉血流速度（CBFV）。双嘧达莫与静息状态下最大舒张期速度之比（D/R PDV）被视为冠状动脉血流储备指标。结果发现，与A组和B组相比，C组和D组的D/R PDV显著降低（D/R PDV分别为1.84±0.57、1.57±0.41，而A组和B组分别为2.59±0.70和2.22±0.58），C组和D组之间的D/R PDV无差异。C组32例患者中有24例D/R PDV小于2.0，D组33例患者中有29例（P>0.05）。高血压患者的D/R PDV、D/R PSV与室间隔厚度、左心室质量指数之间存在显著负相关。这些数据表明，高血压左心室肥厚患者的CFR受损程度与冠心病患者相当。
