Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but "normal" coronary angiography
Abnormal epicardial coronary resistance in patients with diffuse atherosclerosis but "normal" coronary angiography
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DOI：
10.1161/hc4501.099316
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发表时间：
2001-11-13
期刊：
影响因子：
37.8
通讯作者：
Wijns, W
中科院分区：
文献类型：
--
作者：
De Bruyne, B;Hersbach, F;Wijns, W
背景：冠状动脉造影没有局灶性狭窄通常被认为是无血流限制的。然而，动脉粥样硬化是一个弥漫性的过程，通常在血管造影中是看不见的。因此，我们假设在冠状动脉疾病患者中，非狭窄冠状动脉由于弥漫性冠状动脉粥样硬化导致其长度上的压力降低。方法与结果：10例无动脉粥样硬化患者的37条动脉（ⅰ组）和62例其他冠状动脉狭窄患者的106条非狭窄动脉（ⅱ组）的冠状动脉压力和分数血流储备（FFR）作为冠状动脉传导指标。在I组，主动脉和冠状动脉远端之间的压力梯度在静止时最小（1 +/-1 mm Hg），在最大充血时最小（3 +/-3 mm Hg）。II组的相应值明显较大（分别为5 +/-4 mm Hg和10 +/-8 mm Hg）
Background-Coronary arteries without focal stenosis at angiography are generally considered non-flow-limiting. However, atherosclerosis is a diffuse process that often remains invisible at angiography. Accordingly, we hypothesized that in patients with coronary artery disease, nonstenotic coronary arteries induce a decrease in pressure along their length due to diffuse coronary atherosclerosis.Methods and Results-Coronary pressure and fractional flow reserve (FFR), as indices of coronary conductance, were obtained from 37 arteries in 10 individuals without atherosclerosis (group I) and from 106 nonstenotic arteries in 62 patients with arteriographic stenoses in another coronary artery (group II). In group I, the pressure gradient between aorta and distal coronary artery was minimal at rest (1 +/-1 mm Hg) and during maximal hyperemia (3 +/-3 mm Hg). Corresponding values were significantly larger in group II (5 +/-4 mm Hg and 10 +/-8 mm Hg, respectively; both P