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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2006年第5期

页码:

536-538

栏目:

临床研究

出版日期:

2006-10-25

文章信息/Info

Title:

Influence of degree of right coronary artery lesion on left ventricular ejection fraction in patients with left coronary artery stenosis

作者:

江时森; 黄浙勇

南京军区总医院/南京大学医学院临床学院 心血管内科, 江苏 南京 210002

Author(s):

JIANG Shi-sen;  HUANG Zhe-yong

Department of Cardiology, Nanjing General Hospital, Nanjing Military Area Command, Nanjing,Jiangsu 210002, China

关键词:

左室射血分数; 冠状动脉疾病; 冠状动脉造影术

Keywords:

left ventricular ejection fraction;  coronary disease;  coronary angiography

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的 研究右冠状动脉不同程度狭窄对左冠状动脉狭窄患者左室射血分数（LVEF）的影响。方法 根据左冠状动脉病变部位不同，将1 000例左冠状动脉狭窄患者分为左前降支（LAD）狭窄，左回旋支（LCX）狭窄,左主干（LM）狭窄，左前降支+左回旋支（LAD+LCX）狭窄4个系列。每个系列再根据右冠状动脉(RCA)病变程度不同分为RCA正常组（直径狭窄＜50％）、RCA非闭塞组（99%>直径狭窄≥50％）和RCA闭塞组（直径狭窄≥99％），比较分析3组间LVEF的差异。结果 在LAD，LCX，LM，LAD+LCX狭窄时，与RCA正常组LVEF相比，RCA非闭塞组LVEF分别下降0.9％，0.3％，3.4％和2.8％；RCA闭塞组LVEF分别下降10.9％，3.7％，6.5％和5.2％。LAD狭窄时，RCA非闭塞组和RCA闭塞组之间LVEF有统计学差异（P<0.01）。结论 右冠状动脉病变可在左冠状动脉狭窄的基础上使左室射血分数进一步下降；当左冠状动脉狭窄为闭塞性病变时，影响更为明显。

Abstract:

AIM To assess the impact of the degree of right coronary artery(RCA) stenosis on left ventricular ejection fraction (LVEF) in patients with left coronary artery (LCA) stenosis. METHODS One thousand cases with angiographically confirmed LCA stenosis were divided into left anterior descending branch (LAD), left circumflex branch (LCX), left main artery (LM) and LAD+LCX series. Each series was subdivided into 3 groups according to the degree of RCA stenosis: normal RCA group, unocclusive RCA group and occlusive RCA group, and LVEF was compared between them. RESULTS Compared with accordant normal RCA group, LVEF in unocclusive RCA group decreased 0.9%（LAD stenosis）, 0.3%（LCX stenosis）, 3.4%（LM stenosis） and 2.8％（LAD+LCX stenosis） respectively, while that in the occlusive RCA group decreased 10.9%（LAD stenosis）, 3.7％（LCX stenosis）, 6.5%（LM stenosis）and 5.2%（LAD+LCX stenosis）respectively. Only in LCA stenosis series, LVEF between the unocclusive RCA group and the occlusive RCA group showed statistical significance（P<0.01）. CONCLUSION RCA stenosis can aggravate reduction in LVEF in patients with LCA stenosis. The impact of RCA stenosis on LVEF is more obvious when RCA has occlusive stenosis.

参考文献/References

［1］ 江时森, 黄浙勇, 汤沂. 冠状动脉病变程度对左室射血分数的影响研究［J］. 微循环学杂志， 2005， 15(1):45-48.

［2］ 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(11):998-1001.

［3］ 江时森, 黄浙勇, 汤沂, 等. 右冠状动脉病变对左冠状动脉狭窄患者左心室功能的影响［J］. 中国动脉硬化杂志， 2005， 13(1):85-87.

［4］ 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(1): 80-91.

［5］ White M, Rouleau 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(6):1056-1064.

［6］ 黄浙勇, 江时森, 汤沂. 单纯右冠状动脉狭窄对左心室功能的影响［J］. 心脏杂志, 2005， 17(3): 253-255.

［7］ Li KS, Santamore WP. Contribution of each wall to biventricular function［J］. Cardiovasc Res, 1993， 27(5): 792-800.

备注/Memo

备注/Memo:

收稿日期：2005-06-29.作者简介：江时森,主任医师，教授 Tel：(025)80860122 Email：zheyonghuang@126.com

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