Transluminal, subselective measurement of coronary artery blood flow velocity and vasodilator reserve in man.
Transluminal, subselective measurement of coronary artery blood flow velocity and vasodilator reserve in man.
复制标题
DOI：
10.1161/01.cir.72.1.82
复制
发表时间：
1985-07
期刊：
影响因子：
37.8
通讯作者：
R. F. Wilson;Donald E. Laugh;In;P. Ackell;W. Chilian;Myrl Holida;C. J. Hartley;Mark L. Armstrong;MELVtN L. Marcus;Carl W. White
中科院分区：
文献类型：
--
作者：
R. F. Wilson;Donald E. Laugh;In;P. Ackell;W. Chilian;Myrl Holida;C. J. Hartley;Mark L. Armstrong;MELVtN L. Marcus;Carl W. White
在导管室中对冠状动脉血流量和个体冠状动脉的血管扩张储备能力的评估受到方法学限制的阻碍。我们已经开发并验证了一种小型多普勒导管，可以亚选择性地测量相位冠状动脉血流速度（CBFV）。在7头麻醉小牛中，CBFV变化范围为对照CBFV的0.1至5.7倍。通过导管在左前降支和左回旋支动脉管腔内测量的平均CBFV变化与心外膜多普勒探头在同一血管表面同时测量的CBFV变化相似（n = 85，r = 0.95，斜率= 1.04）和用定时静脉采集测量的冠状窦流量变化（n = 69，r = 0.97，斜率= 1.06）。在所研究的动脉中存在和不存在导管的情况下，相同的最大冠状动脉反应性充血反应表明导管引起的冠状动脉阻塞最小。在另外6头小牛中进行的安全性研究表明，导管引起冠状动脉内皮通透性的微小变化。组织学研究显示无内皮剥脱或血栓形成。在70例研究患者中，58例获得了稳定的冠状动脉血流速度相位记录。研究的70名患者中，有1名患者出现突然的冠状动脉闭塞，可能与导管引起的血管痉挛有关。在10例正常患者中，冠状动脉内注射泛影葡胺使CBFV增加至静息时的3.5倍（范围为2.8至5.0）。静脉输注潘生丁后CBFV升高5.0倍（范围3.8至7.0）。在每例患者中，双嘧达莫比泛影葡胺产生更大的血管舒张作用。潘生丁输注的时间和剂量反应特征是异质性的，强调了连续在线测量CBFV在测量血管舒张储备方面的优势。在导管室中测量CBFV和评估血管舒张储备的这种方法应有助于研究人的冠状动脉循环。
Assessment of coronary blood flow and the vasodilator reserve capacity of individual coronary arteries in the catheterization laboratory has been hampered by methodologic limitations. We have developed and validated a small Doppler catheter that can subselectively measure phasic coronary blood flow velocity (CBFV). In seven anesthetized calves, CBFV was varied from 0.1 to 5.7 times control CBFV. Changes in mean CBFV measured intraluminally by catheter in the left anterior descending and left circumflex arteries were similar to those measured simultaneously with an epicardial Doppler probe on the surface of the same vessel (n = 85, r = .95, slope = 1.04) and to changes in coronary sinus flow (n = 69, r = .97, slope = 1.06) measured with timed venous collections. Identical maximal coronary reactive hyperemic responses with the catheter present and absent in the artery being studied demonstrated that coronary obstruction by the catheter was minimal. Safety studies in six additional calves demonstrated that the catheter caused small changes in coronary endothelial permeability. Histologic studies revealed no endothelial denudation or thrombus formation. Stable phasic recordings of coronary blood flow velocity have been obtained in 58 of 70 patients studied. One of the 70 patients studied had abrupt coronary occlusion probably related to catheter-induced vasospasm. In 10 normal patients, intracoronary meglumine diatrizoate increased CBFV to 3.5 times that at rest (range 2.8 to 5.0). CBFV rose 5.0-fold after an intravenous infusion of dipyridamole (range 3.8 to 7.0). In each patient, dipyridamole produced greater vasodilation than meglumine diatrizoate. The time- and dose-response characteristics to dipyridamole infusion were heterogeneous, underscoring the advantage of continuous on-line measurement of CBFV in the measurement of vasodilator reserve. This method of measuring CBFV and assessing vasodilator reserve in the catheterization laboratory should facilitate studies of the coronary circulation in man.