Regional coronary venous flow responses to transient coronary artery occlusion in human beings.
Regional coronary venous flow responses to transient coronary artery occlusion in human beings.
复制标题
人类短暂冠状动脉闭塞的区域冠状静脉血流反应。
DOI：
10.1016/s0735-1097(83)80370-2
复制
发表时间：
1983
影响因子：
24
通讯作者：
C. Pepine
中科院分区：
文献类型：
--
作者：
R. Feldman;C. Conti;C. Pepine
采用局部冠状静脉热稀释法测量局部冠状静脉血流，观察21例短暂性冠状动脉闭塞患者的冠状动脉血流动力学反应。冠状动脉痉挛（13例）或冠状动脉成形术中球囊膨胀（8例）造成短暂性冠状动脉闭塞。冠状动脉左前降支短暂闭塞12例，右冠状动脉短暂闭塞8例，左旋支短暂闭塞1例。短暂性冠状动脉闭塞期间，21例患者中有20例局部静脉流量下降（79±31 ~ 53±29 ml/min，平均值±标准差[SD]；概率[p] < 0.05），对应于被闭塞动脉灌注的左心室区域。所有21个区域的冠状动脉阻力均增加（1.42±0.75至2.26±1.45 mm Hg/ml / min, p < 0.05）。同时测量的由未闭塞动脉供应的左室区血流量和阻力无明显变化（分别为62±27 ~ 64±29 ml/min和1.85±0.93 ~ 1.81±0.98 mmhg /ml /min）。冠状动脉血流动力学变化在短暂性冠状动脉闭塞期间相似，无论是由冠状动脉痉挛还是由球囊膨胀引起。然而，冠状动脉痉挛时心绞痛、可逆性心电图异常和左心室充盈压升高更为常见（p < 0.05）。短暂性冠状动脉前降支、旋支或右冠状动脉闭塞时冠状动脉局部血流动力学变化相似。这些数据表明冠状动脉闭塞减少了受影响动脉灌注区域的局部左心室血流。冠状动脉闭塞的方法和闭塞过程中受影响的冠状动脉似乎没有引起不同的反应。
Coronary hemodynamic responses to transient coronary artery occlusion in 21 patients were investigated by using regional coronary venous thermodilution to measure regional coronary venous flows. Transient coronary artery occlusion was produced by coronary artery spasm (13 patients) or balloon inflation during coronary angioplasty (8 patients). The left anterior descending coronary artery was transiently occluded in 12 patients, the right coronary artery in 8 patients and the left circumflex artery in 1 patient. During transient coronary occlusion, regional venous flow decreased in 20 of the 21 patients (79 ± 31 to 53 ± 29 ml/min, mean ± standard deviation [SD]; probability [p] < 0.05) corresponding to the left ventricular region perfused by the occluded artery. Regional coronary resistance increased in all 21 of these regions (1.42 ± 0.75 to 2.26 ± 1.45 mm Hg/ml per min, p < 0.05). Simultaneously measured blood flow and resistance in the left ventricular region supplied by the nonoccluded arteries did not change significantly (62 ± 27 to 64 ± 29 ml/min and 1.85 ± 0.93 to 1.81 ± 0.98 mm Hg/ml per min, respectively).Coronary hemodynamic changes were similar during transient coronary occlusion, whether produced by coronary spasm or by balloon inflation. However, the presence of angina, reversible electrocardiographic abnormalities and an increase of the left ventricular filling pressure were more common during coronary spasm (p < 0.05 for all). Regional coronary hemodynamic changes during transient occlusion of the anterior descending, circumflex or right coronary artery were similar. These data show that coronary occlusion decreases regional left ventricular flow in the region perfused by the affected artery. The method of coronary occlusion or the coronary artery affected during occlusion did not seem to elicit different responses.