冠状动脉血流显像检测静息状态下左前降支狭窄的异常血流动力学表现

Resting abnormal haemodynamics in stenotic left anterior descending coronary artery detected by transthoracic coronary color Doppler echocardiography

目的探讨经胸冠状动脉血流显像技术无创性检测左前降支狭窄时静息状态下的异常血流动力学表现。方法回顾性分析75例患者冠状动脉造影术前经胸冠状动脉血流显像检测的左前降支相关血流参数,比较冠状动脉造影证实的左前降支狭窄组(程度≥60%)与对照组(程度<60%或正常)相关参数的差异。结果左前降支狭窄组存在局部血流加速、左前降支远端或前间隔分支内逆向血流。血流加速前的血流参数与对照组比较差异无显著性意义,血流加速处、左前降支远段相关血流参数与对照组比较差异有显著性意义,血流加速处与血流加速前相关血流参数的比较差异也有显著性意义。结论静息状态下左前降支狭窄程度≥60%时表现为狭窄处与狭窄前舒张期峰值流速之比增高(≥1.5),且左前降支远段舒张期与收缩期峰值流速比值下降,这些参数的异常有助于无创性评价左前降支狭窄。

Objective To evaluate the resting abnormal haemodynamics in stenotic left anterior descending coronary artery using transthoracic coronary color Doppler echocardiography. Methods The data of left anterior descending coronary artery obtained by transthoracic coronary color Doppler echocardiography before angiography were retrospected in 75 patients and compared with those in the control group. Results The patients with stenotie left anterior descending coronary artery were found localized acceleration flow or retrograde flow by echocardiography. There were not significant differences between the parameters of pre- acceleration flow and those of the control group. But there were reversal results when the parameters were compared with those of acceleration flow. The parameters of distal segments in stenotic group were found significant differences compared with those of the control group. Conclusions The resting abnormal haemodynamics in stenotic left anterior descending coronary artery was characterized by an increased ratio （≥1.5） of the stenotic velocity to the pre-stenotic velocity and a decreased ratio of the diastolic velocity to systolic velocity in the distal segment, these parameters were useful in noninvasive diagnosis of stenotic lesion in the left anterior descending coronary artery.