肥厚型心肌病冠状动脉造影特征

Analyses of coronary angiography in patients with hypertrophic cardiomyopathy

目的 了解肥厚型心肌病患者冠状动脉造影有何特征性改变。方法 对我院自 1987年 8月至 1999年 8月 5 0例肥厚型心肌病患者冠状动脉造影资料进行分析。结果 5 0例中 6例冠状动脉为左优势型 ,占 12 %。本组冠状动脉近端平均血管内径测量值 :LM :(5 1± 1 0 )mm ,LADp :(4 2±1 0 )mm ,LCXp :(3 8± 0 9)mm ,RAp :(3 8± 0 9)mm ,与正常左冠状动脉近端平均血管内径 (LM :(4 6±0 6 )mm ,LADp :(3 7± 0 6 )mm ,LCXp :(3 4± 0 6 )mm比较 ,明显增粗 ,P≤ 0 0 5 ,而本组病例右冠状动脉与之比较差异无显著性。冠状动脉肌桥 14例 ,发生率为 2 8% (14 5 0 ) ,其中 12例位于前降支 ,且大多位于其中段。 13例冠状动脉有单支或多支≥ 5 0 %的狭窄病变 ,占 2 6 %。结论 本组冠状动脉造影特点 :冠状动脉左优势型的比例明显增高 ;冠状动脉血管粗大 ,以左冠状动脉增粗为主 ;冠状动脉肌桥发生率高 ,大多出现于前降支中段 ;约 1 4的患者合并冠状动脉狭窄 (≥ 5 0 % )。

To investigate characteristics of coronary angiography in Patients with hypertrophic cardiomyopathy (HC) Methods Coronary angiographic findings in 50 patients with hypertrophic cardiomyopathy from August 1987 to Augest 1999 was studied Results Among 50 patients there were 6 patients (12%) with dominant left coronary arteries In comparison to normal left coronary arteries in Chinese, left coronary arteries dimensions were significantly larger in those with HC [HC, LM: (5 1±1 0) mm, LADp: (4 2±1 0)mm, LCXp: (3 8±0 9) mm, RAp: (3 8±0 9) mm; Normal LM (4 6±0 6) mm, LADp: (3 7±0 6) mm, LCXp: (3 4±0 6) mm, P ≤0 05) Fourteen patients (28%) had coronary myocardial bridges, 12 of which located at the left anterior descending arteries Thirteen patients (26%) had coronary artery stenosis (≥50%) Conclusion The characteristics of coronary angiography in our patients with HC included higher percentage of dominan left coronary artery and larger coronary arteries (particulaly in left coronary arteries), as well as higher incidence of coronary myocardial bridge About 1/4 patients had coronary artery stenosis (≥50%)