单纯右冠状动脉狭窄对左心室功能的影响

Influence of isolated right coronary artery stenosis on left ventricular function

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。

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.