Pathophysiological studies of regulation and reserve of coronary circulation

本研究的目的是使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学，特别是冠状动脉血流储备（CFR）。1）实验研究。将20 MHz的超声晶体连接到导管的尖端，可以获得高精度的冠状动脉血流速度记录。记录也可以在高速血流中进行，例如反应性充血反应。2）人体冠状动脉血流。用多普勒导管记录人冠状动脉血流速度。该器械在临床应用过程中的安全性也得到了认可。在几乎正常的冠状动脉中，由于流速数据过于分散，很难获得流量的绝对值。然而，似乎流速相对变化的估计是可靠的。我们证实了先前的数据，罂粟碱增加冠状动脉血流量在正常静息值的3 - 7倍，和冠状动脉血流储备在病理心脏可以估计药物。3）CFR在心绞痛患者。测定心绞痛患者PTCA前后CFR。随着冠脉狭窄程度的降低，CFR甚至在PTCA后立即显著增加。冠状动脉狭窄程度与CFR呈显著负相关。

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.