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

Influence of Right Coronary Artery Lesion on Left Ventricular Function in Patients with Left Coronary Artery Stenosis

目的 探讨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及其机制。方法 对比分析左冠状动脉狭窄患者在合并与不合并右冠状动脉病变时的左心室射血分数。结果 与相应部位单纯左冠状动脉狭窄患者相比 ,合并右冠状动脉病变患者左心室射血分数均呈不同程度地下降 ,其中在左前降支、左前降支 +左回旋支狭窄基础上合并右冠状动脉病变时左心室射血分数下降有统计学意义 (P <0 .0 5或 0 .0 1) ,左主干合并右冠状动脉狭窄患者下降幅度最大 ,但无统计学意义。结论 右冠状动脉病变可在单纯左冠状动脉狭窄的基础上使左心室收缩功能进一步恶化 ;当左冠状动脉狭窄部位为左前降支、左主干或左前降支 +左回旋支时 。

Aim To assess the impact of right coronary artery (RCA) lesion on left ventricular ejection fraction(LVEF) in patients with left coronary artery (LCA) stenosis. Methods 1 000 cases with LCA stenosis were confirmed by coronary angiography. LVEF was compared between the group with isolated LCA stenosis and the group with both LCA and RCA stenosis. The group with isolated LCA stenosis included left anterior descending branch (LAD) stenosis, left circumflex branch (LCX) stenosis, left main artery (LM) stenosis and LAD+LCX stenosis. Results Compared with the accordant group with isolated LCA stenosis, LVEF decreased to different extent in every group with RCA stenosis. The changes in LAD+RCA group and LAD+LCX+RCA group were statistically significant (P<0.05 or 0.01). LVEF in LM+RCA group showed the greatest decrease, while in LCX+RCA group showed the slightest decrease without statistical significance. Conclusions RCA stenosis aggravates the left ventricular systolic function in patients with LCA stenosis, especially when the LCA lesion is located in LM or LAD or LAD+LCX.