CORONARY FLOW RESERVE AND ABNORMAL LEFT VENTRICULAR RESPONSE TO EXERCISE

冠状动脉血流储备和左心室运动反应异常

• 批准号: 3843398
• 负责人: R O CANNON
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3843398
• 关键词: adenosine; angina pectoris; angiocardiography; blood flow measurement; cardiovascular function; cardiovascular pharmacology; coronary disorder; coronary vasodilator; ergolines; exercise; heart circulation; heart ventricle; human subject; microcirculation; rest; stress

A subset of patients with chest pain and normal coronary angiograms are believed to have coronary microvascular dysfunction which limits coronary flow reserve. In order to assess whether pharmacologic measures of coronary flow reserve correlate with responses of the left ventricle to stress, we measured coronary flow velocity in the left main coronary artery of 27 patients with chest pain and normal coronary angiograms and normal left ventricular function at rest. The increase in coronary flow velocity over baseline following adenosine, a potent coronary microvascular vasodilator in 10 patients with abnormal left ventricular responses to exercise by radionuclide angiography was no different from that of 17 patients with normal left ventricular responses to exercise. However, repeat assessment of coronary flow reserve following ergonovine .15 mg intravenously showed a decline in coronary flow velocity response to adenosine in the 10 patients with abnormal left ventricular responses to exercise in contrast to no change in the 17 patients with normal left ventricular responses to exercise. Thus, pharmacologic assessment of coronary flow reserve before and following ergonovine suggests dynamic rather than fixed abnormality of coronary microvascular function is associated with abnormal left ventricular responses to exercise in patients with chest pain despite normal coronary angiograms.

胸痛和冠状动脉造影正常的一部分患者， 被认为患有冠状动脉微血管功能障碍， 冠脉血流储备 为了评估药理学是否 冠状动脉血流储备的测量与左心室的反应相关， 在左心室压力下，我们测量了左主干的冠状动脉血流速度， 27例胸痛患者冠状动脉正常 静息时的血管造影和正常左心室功能。 增加 腺苷治疗后冠状动脉血流速度高于基线， 10例左冠状动脉微血管舒张功能异常患者 放射性核素血管造影显示无运动心室反应 与17例左室正常者不同 对锻炼的反应。 然而，重复评估冠状动脉血流 麦角新碱0.15 mg静脉注射后的储备显示， 冠状动脉血流速度对腺苷的反应在10例 运动时左心室反应异常 17名左心室运动反应正常的患者。 因此，术前和术后冠状动脉血流储备的药理学评估 麦角新碱提示动态而非固定的异常， 冠状动脉微血管功能与左室功能异常有关 运动时的心室反应 冠状动脉造影正常