Significance of myocardial ischemia as a factor of the development of coronary collateral vessels

1.梗死前心绞痛与急性心肌梗死后左心室功能的关系梗死前心绞痛对急性心肌梗死后左心室功能的保护是有益的，而与梗死相关冠状动脉的早期再灌注无关。另一方面，梗死前心绞痛的缺血预处理在早期再灌注患者的左心室功能保护中起着重要作用，而缺血预处理对持续闭塞的梗死相关冠状动脉患者的左心室功能保护无效2。劳力型心绞痛或急性心肌梗死患者冠状动脉侧支循环的形成在心肌缺血刺激存在的情况下，侧支血管在所有患者中形成。络脉的发展是评估 关于我们 艾德定量表现为受体冠状动脉直径的增加。侧支循环的功能状态取决于侧支血管的解剖学存在和侧支网络的压力梯度。肝素运动疗法对稳定型劳力型心绞痛患者的长期疗效肝素预处理的重复运动有助于改善稳定型劳力型心绞痛患者的运动能力，并且该治疗的有益效果在长期随访期间得以维持。肝素运动治疗后较长时间内，运动负荷相同的铊-201心肌显像严重程度评分显著降低.供区冠状动脉狭窄对侧支循环储备的意义在非狭窄供区冠状动脉患者中，冠状动脉侧支循环随着心肌需氧量的增加而进一步增加，而供区动脉严重狭窄则会损害侧支循环血流量的增加。少

1. Relationship between preinfarction angina and left ventricular function after acute myocardial infarctionPreinfarction angina is useful for the preservation of left ventricular function after acute myocardial function regardless of the early reperfusion of the infarct-related coronary artery The beneficial effect is, at least in part, due to the development of collateral circulation. On the other hand, ischemic preconditioning by preinfarction angina plays an important role in the preservation of left ventricular function in patients with the early reperfusion, whereas ischemic preconditioning is not useful for the preservation of left ventricular function in those with the persistently occluded infarct-related coronary artery2. The development of coronary collateral circulation in patients with effort angina or acute myocardial infarctionIn the presence of myocardial ischemic stimuli, collateral vessels are developed in all patients. The development of collateral channels is assess … More ed quantitatively as an increase in the diameter of recipient coronary arteries. The functional state of collateral circulation is determined by the anatomical presence of collateral vessels and pressure gradient across the collateral network.3. Long-term efficacy of heparin exercise treatment for patients with stable effort anginaRepeated exercise with heparin pretreatment is useful for improving exercise capacity in patients with stable effort angina, and the beneficial effect of the treatment is maintained over a long follow-up period. The severity score of exercise thallium-201 myocardial scintigrams with the same work-load was significantly decreased long after heparin exercise treatnent.4. Significance of stenosis of donating coronary arteries for collateral flow reserveCoronary collateral circulation is further augmented in response to an increase in myocardial oxygen demand in patients with non-stenosed donating coronary arteries, whereas significant stenoses in donating arteries compromise an increase in collaterai blood flow. Less