经胸超声测定冠状窦血流评价左冠状动脉狭窄

目的应用超声心动图等长握力负荷试验定量冠状静脉窦血流以评价左冠状动脉狭窄对冠状窦血流的影响。方法116例接受冠状动脉造影的患者,其中65例为左冠状动脉狭窄,51例造影正常,经胸超声心动图测定等长握力负荷前后两组冠状窦血流参数,并与冠状动脉狭窄程度积分进行比较分析。结果冠状动脉狭窄组负荷后收缩期最大血流速度和舒张期最大血流速度均小于正常组,差异有显著性意义[(51.33±5.60)cm/s比(71.88±5.64)cm/s,(42.37±7.04)cm/s比(55.18±6.01)cm/s;P<0.05]。冠状动脉造影狭窄组血流速度储备及积分储备均较冠状动脉造影正常组减少,差异有显著性(1.35±0.12比1.61±0.22,1.49±0.18比1.96±0.44;P<0.05)。冠状动脉狭窄组血流积分储备与冠状动脉狭窄积分具有显著相关性(r=-0.76,P<0.01)。结论无创性超声心动图测定冠状窦血流可以初步评价冠状动脉狭窄。

Estimation of Left Coronary Stenosis by Coronary Sinus Blood Flow Using Transthoracic Echocardiography

Aim To seek the feasibility of quantity coronary sinus flow for estimation the left coronary stenosis influlence to coronary sinus flow by holdgrip exercise echocardiorgraphy.MethodsCoronary sinus flow velocity recordings before and after holdgrip exercise echocardiography were measured.116 patients accepted coronary angiography,of which 65 had stenosis,51 were normal.The grade of stenosis was estimated by Gensini index.The correlation between the coronary sinus flow and the Gensini index were analyzed.ResultsThe peak systolic flow velocity and peak dilatic flow velocity of coronary stenosis were significantly lower than the normal angiography(51.33±5.60 cm/s vs 71.88±5.64 cm/s,42.37±7.04 cm/s vs 55.18±6.01 cm/s,p<0.05).Coronary sinus index reserve(CSIR) and coronary sinus velocity reserve(CSVR) in coronary stenosis group were lower than those in the normal angiography(1.35±0.12 vs 1.61±0.22,1.49±0.18 vs 1.96±0.44,p<0.05).CSVR had a significant negative correlation with the Gensini index(r=-0.76,p<0.01).ConclusionsCoronary sinus flow measurement by transthoracic echocardiorgraphy can be used for estimating the coronary stenosis.