Senti S, Fleisch M, Billinger M, Meier B, Seiler C
Section of Cardiology, University Hospital, Bern, Switzerland.
J Am Coll Cardiol. 1998 Jul;32(1):49-56. doi: 10.1016/s0735-1097(98)00181-8.
This prospective, cross-sectional study sought to determine an association between the level of long-term physical activity as well as other clinical and angiographic variables and an index of collateral flow to the vascular region undergoing percutaneous transluminal coronary angioplasty (PTCA).
There is limited and conflicting information about the effect of physical exercise on the coronary collateral circulation in humans, partly because previous studies lacked a quantitative means of assessing collateral channels.
In 79 patients (mean [+/-SD] age 58 +/- 10 years) with coronary artery disease undergoing PTCA (no transmural myocardial infarction), a coronary collateral flow index was determined as the ratio between the intracoronary (IC) distal flow velocity time integral during (Vi(occl)[cm]) and after (Vi(occl) [cm]) PTCA of the stenosis. Vi(occl)/Vi(occl) was measured by a 0.014-in. Doppler guide wire, from which an IC electrocardiogram (ECG) was also recorded. Patients without ECG ST-T wave changes during PTCA were considered to have sufficient collateral channels (n = 29); those with ST-T wave changes were considered to have insufficient collateral channels (n = 50). The level of long-term physical activity was determined by a structured interview (score from 1 to 4). Univariate and multivariate analyses were used to find associations between physical activity as well as 30 other clinical and angiographic variables and the collateral flow index.
Long-term physical activity during leisure time, but not during work hours, and the severity of the stenosis undergoing PTCA were found to be independently and directly associated with sufficient versus insufficient collateral channels and with Vi(occl) Vi(occl) (leisure time physical activity [LTPA] score 3.3 +/- 0.9 vs. 2.4 +/- 1.0, p = 0.0002; percent diameter stenosis 88 +/- 12% vs. 80 +/- 14%, p = 0.001; Vi(occl)/Vi(occl) = 0.1 +/- 0.1 LTPA score, p = 0.0002 for trend).
In patients with coronary artery disease, the level of long-term physical activity during leisure time and the severity of the stenosis undergoing PTCA are directly associated with the quantitative degree of collateral flow.
本前瞻性横断面研究旨在确定长期体力活动水平以及其他临床和血管造影变量与经皮腔内冠状动脉成形术（PTCA）所涉及血管区域的侧支血流指数之间的关联。
关于体育锻炼对人体冠状动脉侧支循环的影响，现有信息有限且相互矛盾，部分原因是既往研究缺乏评估侧支血管的定量方法。
在79例接受PTCA（无透壁性心肌梗死）的冠心病患者（平均年龄[±标准差]58±10岁）中，冠状动脉侧支血流指数被确定为狭窄部位PTCA期间（Vi(occl)[cm]）和之后（Vi(occl)[cm]）冠状动脉内（IC）远端血流速度时间积分的比值。Vi(occl)/Vi(occl)通过0.014英寸的多普勒导丝测量，同时记录IC心电图（ECG）。PTCA期间无ECG ST-T波改变的患者被认为有足够的侧支血管（n = 29）；有ST-T波改变的患者被认为侧支血管不足（n = 50）。长期体力活动水平通过结构化访谈确定（评分1至4分）。采用单因素和多因素分析来寻找体力活动以及其他30个临床和血管造影变量与侧支血流指数之间的关联。
发现闲暇时间而非工作时间的长期体力活动以及接受PTCA的狭窄严重程度与侧支血管充足与否以及Vi(occl)/Vi(occl)独立且直接相关（闲暇时间体力活动[LTPA]评分3.3±0.9 vs. 2.4±1.0，p = 0.0002；直径狭窄百分比88±12% vs. 80±14%，p = 0.001；Vi(occl)/Vi(occl)=0.1±0.1 LTPA评分，趋势p = 0.0002）。
在冠心病患者中，闲暇时间的长期体力活动水平以及接受PTCA的狭窄严重程度与侧支血流的定量程度直接相关。
