冠状动脉侧支循环对其病变程度与左室功能关系的影响

Effects of coronary collateral circulation on the relationship between the severity of coronary lesions and left ventricular function in patients with coronary heart disease

目的探讨冠心病患者冠状动脉病变程度与左室功能的关系。方法３６例选择性冠状动脉造影主要分支狭窄≥７０％的患者作Ｌｅａｍａｎ冠状动脉记分，左室造影测左室射血分数（ＬＶＥＦ），左室壁运动作Ｃｏｒｔｉｎａ记分，研究侧支循环对Ｌｅａｍａｎ冠状动脉记分与ＬＶＥＦ及Ｃｏｒｔｉｎａ记分间关系的影响。结果全组Ｌｅａｍａｎ冠状动脉记分与ＬＶＥＦ及Ｃｏｒｔｉｎａ左室壁运动记分无相关，但在无侧支循环建立的亚组，Ｌｅａｍａｎ冠状动脉记分与ＬＶＥＦ呈负相关（ｒ＝－０．６４，Ｐ＜０．０１），与Ｃｏｒｔｉｎａ左室壁运动记分呈显著正相关（ｒ＝０．７３，Ｐ＜０．０１）。结论冠状动脉病变程度与左室功能间的关系取决于严重病变的冠状动脉有无建立侧支循环。侧支循环的建立对冠心病患者的左室功能有保护作用。

Objective To investigate the relationship between the severity of coronary artery involvement and left ventricular function in patients with coronary artery disease. Methods In 36 patients with fixed stenosis coronary artery ≥70% of luminal diameter in the major coronary arteries , the effect of collateral circulation on the relationships between the Leaman coronary artery score and left ventricular ejection fraction as well as left ventricular wall motion Cortina score were assessed. Results The Leaman coronary artery score related to neither the left ventricular ejection fraction nor the left ventricular wall motion Cortina score in the whole group. Yet, in the subgroup without establishment of collateral circulation, the Leaman coronary artery score had significantly negative correlation to left ventricular ejection fraction ( r =-0.64, P <0.01) and positve correlation to left ventricular wall motion Cortina score ( r =0.37, P <0.01).Conclusion The relationship between the severity of coronary involvement and left ventricular function depends on whether the patient has developed collateral circultion, which plays an important role in the protection of left ventricular function in patients with coronary artery disease.