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冠状动脉侧支循环对其病变程度与左室功能关系的影响


马虹 黄战军 杜志民 胡承恒 董吁钢
叶慧膺 何建桂 廖晓星 廖新学



  【摘要】 目的 探讨冠心病患者冠状动脉病变程度与左室功能的关系。方法 36例选择性冠状动脉造影主要分支狭窄≥70%的患者作Leaman冠状动脉记分,左室造影测左室射血分数(LVEF),左室壁运动作Cortina记分,研究侧支循环对Leaman冠状动脉记分与LVEF及Cortina记分间关系的影响。结果 全组Leaman冠状动脉记分与LVEF及Cortina左室壁运动记分无相关,但在无侧支循环建立的亚组,Leaman冠状动脉记分与LVEF呈负相关(r=-0.64,P<0.01),与Cortina左室壁运动记分呈显著正相关(r=0.73,P<0.01)。结论 冠状动脉病变程度与左室功能间的关系取决于严重病变的冠状动脉有无建立侧支循环。侧支循环的建立对冠心病患者的左室功能有保护作用。
  【关键词】 冠状动脉疾病  心室功能,左  侧支循环

Effects of coronary collateral circulation on the relationship between the severity of coronary lesions and left ventricular function in patients with coronary heart disease   Ma Hong, Huang Zhanjun, Du Zhiming, et al. Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University of Medical Sciences, Guangzhou 510080
  【Abstract】 Objective To investigate the relationship between the severity of coronary artery involvement and left ventricular function in patients with coronary artery disease. Methods In 36 patients with fixed stenosis coronary artery ≥70% of luminal diameter in the major coronary arteries , the effect of collateral circulation on the relationships between the Leaman coronary artery score and left ventricular ejection fraction as well as left ventricular wall motion Cortina score were assessed. Results The Leaman coronary artery score related to neither the left ventricular ejection fraction nor the left ventricular wall motion Cortina score in the whole group. Yet, in the subgroup without establishment of collateral circulation, the Leaman coronary artery score had significantly negative correlation to left ventricular ejection fraction (r=-0.64, P<0.01) and positve correlation to left ventricular wall motion Cortina score (r=0.37, P<0.01).Conclusion The relationship between the severity of coronary involvement and left ventricular function depends on whether the patient has developed collateral circultion, which plays an important role

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