摘要
目的:比较多巴酚丁胺负荷心肌血流量(MBF)、心率-收缩压乘积(RPP)与冠心病(CAD)患者动脉狭窄程度的关系。方法:将27例单支血管CAD患者根据狭窄程度分为3组:组1狭窄程度为50%～69%(n=9);组2为70%～89%(n=9);组3≥90%(n=9)。9例健康志愿者作为对照组。用正电子发射断层扫描测量狭窄阻断区域(Isc)和远端心肌(Rem)的静息和多巴酚丁胺负荷MBF。将平均左室MBF作为对照。
Objectives: To compare the relationship between dobutamine myocardial blood flow (MBF), rate-pressure product(RPP)and stenosis severity in patients with coronary artery disease (CAD). Methods: 27 patients with single-vessel CAD were allocated to three groups based on stenosis severity: group 1, 50-69%(n=9); group 2, 70-89%(n=9); and group 3, ≥90%(n=9). Nine normal volunteers served as controls. Resting and dobutamine MBF were measured by positron emission tomography in the territory subtended by the stenosis (Isc) and remote myocardium (Rem). Mean left ventricular MBF was used for controls. Results: In group 1, mean dobutamine MBF-Isc(2.48(SD 0.48)ml/min/g) and dobutamine MBF-Rem(2.70(0.50) ml/min/g, NS) were comparable. In groups 2 and 3, dobutamine MBF-Isc (1.91(0.44) and 1.22(0.21) ml/min/g) was significantly lower than dobutamine MBF-Rem (2.27(0.28) and 1.98 (0.25) ml/min/g, p< 0.02 and p< 0.005, respectively). An inverse relation between dobutamine MBF and stenosis severity existed both in Isc (r=0.79, p< 0.001) and in Rem territories (r=0.71, p< 0.001). For any given RPP, dobutamine MBF was greater in controls than in Rem (p< 0.05), which in turn was greater than in Isc (p< 0.05). Conclusion: Dobutamine MBF inversely correlated with stenosis severity and achieved significant flow heterogeneity for coronary stenoses >70%. Dobutamine MBF and RPP were dissociated in both Isc and Rem segments in patients compared with controls.
