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|本期目录/Table of Contents|

单纯右冠状动脉狭窄对左心室功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
253-255
栏目:
临床研究
出版日期:
2005-05-05

文章信息/Info

Title:
Influence of isolated right coronary artery stenosis on left ventricular function
作者:
黄浙勇;  江时森;  汤沂
南京军区南京总医院/南京大学医学院临床学院心内科, 江苏 南京 210002
Author(s):
HUANG Zheyong;  JIANG Shisen;  TANG Yi
Department of Cardiology, Clinical School of Medical College of Nanjing University/ Nanjing General Hospital of Nanjing Command, Nanjing, Jiangsu 210002,China
关键词:
冠状动脉狭窄; 心室功能; 左; 左室射血分数; 冠状动脉造影术
Keywords:
coronary artery stenosis;  left ventricular function;  left ventricular ejection fraction;  coronary angiography
分类号:
R543.3
DOI:
-
文献标识码:
A
摘要:
目的 探讨单纯右冠状动脉（RCA）狭窄不同狭窄程度和狭窄节段对左心室功能的影响。方法 将冠状动脉造影证实为单纯RCA狭窄的患者99例，按不同狭窄程度、不同狭窄节段和不同冠脉优势型进行分组，并与494例无冠状动脉狭窄的对照组比较，经左心室造影测定的左室射血分数(LVEF)和左室舒张末压(LVEDP)。结果 与对照组患者相比，轻度、中度和重度单纯右RCA狭窄患者的LVEF变化不显著，完全闭塞患者的LVEF显著下降（P<0.05）；右冠中段、右冠远段、后降支和侧后支病变患者的LVEF均无有意义变化，右冠近段病变患者LVEF下降有统计学意义（P<0.05）。单纯RCA狭窄患者中，右冠优势组LVEF略低于均衡优势组和左冠优势组，但差异未达显著水平。单纯RCA狭窄对LVEDP的影响并不明显。结论 单纯RCA主干近段狭窄和单纯RCA完全闭塞对左室收缩功能可产生一定程度的损害。
Abstract:
AIM To assess the impact of the severity and location of right coronary artery(RCA) lesions on the left ventricular function in patients with isolated RCA stenosis. METHODS 99 cases with isolated RCA stenosis confirmed angiographically were grouped in terms of severity and location of RCA lesions. Their left ventricular ejection fraction(LVEF), left ventricular end diastolic pressure(LVEDP) measured by ventriculography were compared with those of the control group with no significant coronary lesions. RESULTS Compared with the control group, LVEF was significantly decreased in both the totally RCA occlussion group（P<0.05）, and the RCA proximal lesion group（P<0.05）. Among cases with isolated RCA stenosis, LVEF in the RCA dominance group was slightly lower than those in left coronary artery(LCA) dominance group and codominance group, although without statistical significance. There was no obvious impact of isolated RCA stenosis on LVEDP. CONCLUSION Total RCA occlussion and RCA proximal lesion in patients with isolated RCA stenosis undermine left ventricular systolic function.

参考文献/References

［1］ Danton MH, Byrne JG, Flores KQ, et al. Modified Glenn connection for acutely ischemic right ventricular failure reverses secondary left ventricular dysfunction［J］. J Thorac Cardiovasc Surg,2001, 122: 80-91.

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［3］ White M, Roulean JL, Hall C, et al. Changes in vasoconstrictive hormones, natriuretic peptides and left ventriclar remodeling soon after myocardial infarction［J］. Am Heart J, 2001,142:1056-1064.

［4］ 江时森, 宫剑滨,彭永平，等. 663例冠状动脉造影术及260例冠心病介入治疗临床分析［J］. 中华医学杂志［英文版］, 2004, 117(suppl):95-97.

［5］ Smiseth OA. Assessment of ventricular diastolic function［J］. Can J Cardio, 2001,17: 1167-1176.

［6］ 黄浙勇,江时森,汤沂. 冠状动脉病变程度对左室舒张末压的影响［J］. 医学研究生学报, 2004,17:998-1001.

［7］ 王晶明,王颖,陈旭春,等. 应用多普勒组织成像评价冠心病患者左心室舒张功能［J］. 心脏杂志,2003, 15: 354-356

［8］ 江时森,陈锐华,宫剑滨,等. 老年冠状动脉支架置入术的临床体会［J］. 医学研究生学报,2003，16 : 194-196.

备注/Memo

备注/Memo:
收稿日期：2004-08-31.
更新日期/Last Update: 2010-01-05