Clinical, angiographic, hemodynamic, perfusional and functional changes after one-vessel left anterior descending coronary angioplasty.
Clinical, angiographic, hemodynamic, perfusional and functional changes after one-vessel left anterior descending coronary angioplasty.
复制标题
单支左冠状动脉前降支血管成形术后的临床、血管造影、血流动力学、灌注和功能变化。
DOI：
10.1016/0002-9149(85)90374-1
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Block,PC
中科院分区：
文献类型：
--
作者：
Okada,RD;Lim,YL;Boucher,CA;Pohost,GM;Chesler,DA;Block,PC
对20例单支冠状动脉前降支病变患者进行了经皮冠状动脉腔内成形术（PTCA）。PTCA术后1周，运动能力（峰值负荷、心率和收缩压）均显著增加。所有患者的狭窄尺寸和梯度均有所降低。除1例患者外，所有患者的功能分级均有所改善。12例术前运动心电图异常者中，8例术后心电图恢复正常。采用计算机定量心肌局部Tl-201分布、再分布和清除率的方法，分析了20例患者PTCA术前和术后1周的运动Tl-201心肌灌注显像。经皮冠状动脉腔内成形术后1周，左室前壁和室间隔的T1 -201活性明显增强。Tl-201摄取的这种增加与相同区域中初始和延迟运动后图像之间的Tl-201再分布量的显著减少相关。Tl-201在扩张血管供血的节段中的清除率也显著提高。17例患者术前和4例患者术后发现肺内T1 -201摄取异常。在所有17例接受运动放射性核素心室造影的患者中，经皮冠状动脉腔内成形术治疗前降支狭窄后，运动射血分数反应和间隔壁运动也得到改善。经皮冠状动脉腔内成形术治疗单支冠状动脉前降支病变后，临床、血管造影和血流动力学因素以及整体和局部心肌灌注和功能均得到改善。
Percutaneous transluminal coronary angioplasty (PTCA) was successfully performed in 20 patients with 1-vessel left anterior descending (LAD) coronary artery disease. Exercise capacity in terms of peak workload, heart rate and systolic blood pressure all increased significantly 1 week after PTCA. All patients had some decrease in stenosis size and gradient. All patients except 1 had an improvement in functional class. Eight of 12 patients with abnormal exercise electrocardiograms before PTCA had normal electrocardiograms after the procedure. Exercise thallium-201 (Tl-201) myocardial perfusion images obtained in all 20 patients before and 1 week after PTCA were analyzed using a new computer method designed to quantitate regional myocardial Tl-201 distribution, redistribution and clearance rate. Significant improvement in Tl-201 activity was present in the anterior and septal segments of the left ventricle 1 week after PTCA. This increase in Tl-201 uptake was associated with a significant reduction in the amount of Tl-201 redistribution between initial and delayed postexercise images in the same regions. Tl-201 clearance rate in the segments supplied by the dilated vessel also improved significantly. Abnormal Tl-201 lung uptake was seen in 17 patients before and in 4 patients after PTCA. Exercise ejection fraction response and septal wall motion also improved after PTCA of the LAD stenosis in all 17 patients who had exercise radionuclide ventriculography. Improvement in clinical, angiographic and hemodynamic factors as well as in global and regional myocardial perfusion and function occurs after PTCA for 1-vessel LAD coronary artery disease.