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功能后左心室功能的保存是有用的，而不管梗死相关冠状动脉早期再灌注，其有益作用至少部分是由于侧枝循环的发展。另一方面，梗死前心绞痛缺血预处理对早期再灌注患者左心室功能的保存起重要作用，而缺血预处理对梗死相关冠状动脉持续闭塞的患者左心室功能的保存不起作用2。急性心绞痛或急性心肌梗死患者冠状动脉侧枝循环的发展在心肌缺血刺激下，所有患者的侧枝血管都有发展。随着受体冠状动脉直径的增加，侧枝通道的发展可以得到更定量的评价。侧支循环的功能状态是由侧支血管的解剖存在和侧支网络的压力梯度决定的。肝素运动治疗稳定苦力型心绞痛患者的远期疗效肝素预处理反复运动有助于提高稳定苦力型心绞痛患者的运动能力，且治疗的有益效果可在较长随访期内保持。3、肝素运动治疗后较长时间，相同工作量的运动铊-201心肌图严重程度评分显著降低。供体冠状动脉狭窄对侧支血流储备的意义供体冠状动脉不狭窄的患者心肌需氧量增加会进一步增强冠状动脉侧支循环，而供体动脉明显狭窄会损害侧支血流的增加。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