冠状动脉慢性闭塞患者侧支循环情况对血管开通后左心功能及预后的影响

Effect of Coronary Collateral Circulation on Left Ventricular Function and Prognosis in Coronary Chronic Total Occlusion Patients after Successful Recanalization

探讨冠状动脉慢性闭塞患者侧支循环情况对血管开通后左心功能及预后的影响。连续入选至少有一支主要冠脉完全闭塞的患者228例,根据Rentrop评分系统对患者冠状动脉侧支情况进行评分,分为侧支生成不良组(Rentrop评分0级和1级,n=106)和侧支生成良好组(Rentrop评分2级和3级,n=122),术后随访12个月,记录基线及随访12个月时左心功能及主要不良心血管事件(MACEs)。侧支生成良好组12个月随访时左室射血分数(LVEF)较侧支生成不良组明显升高(59.7%vs.54.9%,P<0.05)。侧支生成形成良好组MACEs发生率显著低于侧支生成不良组(2.4%vs.9.4%,P<0.05)。冠状动脉慢性闭塞患者侧支循环形成情况对于开通闭塞血管后改善左心功能,降低MACEs发生率有重要作用。

To evaluate the effect of coronary collateral circulation （CCC） on left ventricular function and prognosis in coronary chronic total occlusion （CTO） patients after successful recanalization. A total of 228 patients with chronic total occlusion （at least one major coronary total occlusion） were included in this study. Coronary collateral circulation was graded according to the Rentrop scoring system. There were 106 patients with Rentrop 0 and 1 （poor CCC） and 122 patients with Rentrop 2 and 3 （good CCC）. Cardiac function and major adverse cardiovascular events （MACEs） were observed at baseline and 12months follow-up. Left ventricular function in patients with good CCC were better than those in patients with bad CCC（59.7% vs. 54.9%, P〈0.05）, MACEs morbidity in patients with good CCC were lower than in patients with bad CCC （2.4% vs. 9.4%, P〈0. 05）. Good CCC plays an significant role in improving left ventricular function and reducing MACEs morbidity in CTO patients after successful recanalization.