冠状动脉迂曲患者冠状动脉CT成像和左心室功能分析

Assessment of CT coronary angiography and left ventricular function in patients with coronary tortuosity

目的探讨冠状动脉迂曲与左心室功能受损之间关系。方法收集36例CT检查冠状动脉迂曲无狭窄的患者和36例冠状动脉CT正常的患者,分析比较两组患者的临床特点和超声心动图左心功能各项指标。结果冠状动脉迂曲节段以右冠状动脉后降支、左心室后支、前降支远段及回旋支远段多见,2支病变同时发生14例(38.9%),3支及以上病变7例(19.4%);冠状动脉迂曲组与冠状动脉正常组比较超声心动图二尖瓣口舒张早期血液峰值速度(E)峰减低(63.47±5.03)cm/s vs(84.92±6.57)cm/s(P<0.01),舒张晚期血液峰值速度(A)峰升高(80.36±5.74)cm/s vs(67.36±5.75)cm/s,E/A比值0.94±0.23vs 1.22±0.14,迂曲患者室间隔厚度(11.37±0.90)mm vs(10.57±0.92)mm(P<0.01)和左心室后壁厚度(10.79±0.81)mm vs(10.16±0.86)mm(P<0.01)也较冠状动脉正常组增厚。结论冠状动脉迂曲以右冠状动脉后降支、左心室后支、左冠状动脉前降支远段及回旋支远段多见;冠状动脉迂曲患者多有左心室舒张功能减低。

Objective To evaluate the relationship between tortuosity of coronary artery and left ventricular dysfunction. Methods Thirty-six cases of tortuous coronary without stenosis and 36 cases with normal coronary CT were divided into two groups. The clinical features and the various indicators of left ventricular function in echocardiographic were analyzed. Results The segment of tortuous coronary artery was more common among posterior descending branch and left ventricular posterior of right coronary artery,distal anterior descending and distal circumflex branch. Two lesions of coronary occurred simultaneously in 14 cases,accounting for 38.9%. Three and more lesions were occurred in 7 cases, accounting for 19.4%. The mitral E peak in the group of coronary tortuosity in echoeardiographie was slightly lower than that of the normal（63.47 ± 5.03） cm/s vs （84.92 ± 6.57） cm/s（ P 〈0.01）, and the A peak was slightly higher（80.36±5.74） cm/s vs （67.36±5.75） cm/s（ P 〈0.01） ,E/A ratio 0.94±0.2a vs 1.22i0.14 . The interventricular septal with coronary tortuosity was slightly thicker than normal（11. 37±_0.90） mm vs （10. 57±0.92） mm（ P 〈0.01） ,so was with left ventricular posterior （10.79±0.81） mm vs （10.16±0.86） ram（ P 〈 0.01）. Conclusion The segment of coronary tortuosity was more common among posterior descending branch and left ventricular posterior of right coronary artery, distal anterior descending and distal circumflex branch. The diastolic function of left ventricular was reduced mostly in patients with tortuosity of coronary arteries.