Coronary flow and flow reserve in children
Coronary flow and flow reserve in children
复制标题
儿童冠状动脉血流和血流储备
作者：
G. Óskarsson
主动脉压影响冠脉血流量，但在正常生理血压范围内，冠脉血流量是恒定的。冠脉血流呈搏动性，在舒张期早期最大。有一个较小的收缩期血流成分。右室的低收缩压有利于收缩期血流。右冠状动脉收缩期血流比例大于左冠状动脉。儿童心脏病会引起几种血液动力学和功能改变，这些改变可能会影响心肌灌注。重度主动脉瓣狭窄的新生儿可能出现左冠状动脉的逆行收缩血流。扩张型心肌病的儿童冠脉流量减少与心肌质量有关。冠状动脉血流储备(CFR)被定义为由反应性充血或血管扩张剂引起的最大冠脉血流量除以静息血流量的比率。冠脉流量通常可以增加2.5-4倍。如果由于心肌肥大、劳损或低氧血症导致基础血流量增加，则CFR减少。在手术治疗的先天性心脏病新生儿中，用正电子发射断层扫描测得的CFR值非常低。冠状动脉内多普勒导丝测量冠脉血流速度可作为评价冠脉血流速度和CFR的参考或“金标准”。
Aortic blood pressure affects coronary blood flow, but within the normal physiological blood pressure range coronary blood flow is constant. The coronary flow is pulsatile, being maximal in the early diastole. There is a smaller systolic flow component. The low systolic pressure in the right ventricle favours systolic flow. The proportion of systolic flow is greater in the right than in the left coronary artery. Heart diseases in children cause several haemodynamic and functional changes that are likely to affect myocardial perfusion. Newborns with severe valvular aortic stenosis may have a retrograde systolic flow in the left coronary artery. Children with dilated cardiomyopathy have a reduced coronary flow related to myocardial mass. Coronary flow reserve (CFR) is defined as the ratio of maximal coronary blood flow, as induced by reactive hyperaemia or administration of vasodilators, divided by resting flow. Coronary flow can normally increase 2.5–4‐fold. CFR is reduced if basal flow is increased due to myocardial hypertrophy, strain or hypoxaemia. Very low CFR values measured with positron emission tomography are reported in neonates with surgically treated congenital heart disease. Measurement of coronary flow velocity with the intracoronary Doppler guide wire may be regarded as a reference or “gold standard” in the evaluation of coronary flow velocity and CFR.
一氧化氮是缺氧冠状血管舒张的介质。
影响因子：
20.1
作者：
Park,KH;Rubin,LE;Gross,SS;Levi,R
通讯作者：
Levi,R
影响因子：
10.8
作者：
Miller, FJ;Dellsperger, KC;Gutterman, DD
通讯作者：
Gutterman, DD
人类心房扑动双电位的表征：短暂夹带期间的研究。
影响因子：
24
作者：
Olshansky,B;Okumura,K;Henthorn,RW;Waldo,AL
通讯作者：
Waldo,AL