Pathophysiological studies of regulation and reserve of coronary circulation

本研究的目的是利用多普勒超声导管研究正常和病理心脏的冠状动脉循环的病理生理，特别是冠状动脉血流储备（CFR）。1)实验研究。将20 MHz超声晶体贴在导管尖端，可获得高精度的冠状动脉血流速度记录。在高速血流中，如反应性充血反应，也可以记录这些记录。2)人类冠状动脉血流量。用多普勒导管记录人冠状动脉血流速度。该设计在临床应用中的安全性也得到了认可。由于在几乎正常的冠状动脉中流速数据过于分散，很难获得流量的绝对值。然而，流速的相对变化估计似乎是可靠的。我们证实了先前的数据，罂粟碱使冠状动脉血流量增加了正常静息值的3 - 7倍，并且可以通过药物来估计病理心脏的冠状动脉血流量储备。3)心绞痛患者的CFR。对心绞痛患者行PTCA前后的CFR进行检测。随着冠状动脉狭窄严重程度的降低，即使在PTCA后CFR也显著增加。冠状动脉狭窄程度与CFR呈显著的线性反比关系。

The purpose of the study was to investigate pathophysiology of the coronary circulation, particularly coronary flow reserve (CFR) in normal and pathological hearts using Doppler ultrasonic catheters.1) Experimental studies. Recording of coronary blood flow velocity could be obtained with high accuracy by attaching the 20 MHz ultrasonic crystals to the tip of the catheters. The recordings were also possible in high-speed blood flow, such as reactive hyperemic response.2) Coronary blood flow in humans. Coronary blood flow velocity was recorded in humans by Dopplercatheters. Safety of the devise during clinical application was also recognized. It was difficult to obtain absolute value of the flow volume, since the data of velocity were scattered too much in almost normal coronaries. However, it seemed that estimation of relative change of flow velocity was reliable. We confirmed the previous data that papaverine increases coronary blood flow in three-seven folds of normal resting values, and coronary flow reserve in pathological hearts may be estimated by the drug.3) CFR in patients with angina pectoris. CFR was examined before and after PTCA in patients with angina pectoris. With decrease in severity of coronary stenosis CFR increased significantly even immediately after PTCA. There was significant inverse linear relationship between degree of coronary stenosis and CFR.