经胸冠状动脉多普勒血流显像测定前降支支架植入术后远端血流的临床研究

目的　探讨经胸冠状动脉 (冠脉 )多普勒血流显像评估前降支支架植入术疗效的临床价值。方法　对 19例曾行前降支近段冠脉成形及支架植入术的冠心病患者进行冠脉多普勒血流显像检查 ,观察前降支远端冠脉血流信号 ,记录流速曲线 ,测定舒张期峰值流速 (PVd)、收缩期峰值流速 (PVs)及舒张期与收缩期峰值流速比值 (DSVR) ,并与正常对照组进行比较。结果　 19例患者中 11例前降支及支架内无明显再狭窄 ;8例有 >70 %的支架内再狭窄。无再狭窄组前降支远端血流均能清晰显示 ,PVd、PVs、DSVR与正常对照组差别无显著性意义 ;再狭窄组有 6例可测及前降支远端血流 ,PVd、DSVR明显低于正常对照组及无再狭窄组 ,2例未测及前降支远端血流。结论　经胸冠脉多普勒血流显像能直接观测前降支远端的冠脉血流 ,可为前降支冠脉支架植入术后的效果评估及是否发生再狭窄提供重要信息。

Clinical study of distal left anterior descending artery flow by transthoracic coronary Doppler echocardiography in patients with left anterior descending artery stents

Objective To evaluate the value of the distal left anterior descending coronary artery (LAD) flow velocity measured by transthoracic color Doppler echocardiography (TTCDE) for the noninvasive assessment of the LAD stent implantation. Methods Twelve normal subjects and 19 patients who underwent successful proximal-middle LAD stenting were studied. The distal LAD flow signal was observed and the pulsed-Doppler velocity curve was recorded by TTCDE. The peak diastolic flow velocity (PVd) and the peak systolic flow velocity (PVs) were measured. The diastolic/systolic velocity ratio (DSVR) was calculated. Results According to coronary angiography, 19 patients were divided into 2 groups: 11 patients without re-stenosis were group N and 8 patients with significant re-stenosis (>70%) were group R. The distal LAD flow signal could be observed in all cases in group N and 6 cases in group R. The PVd, PVs and DSVR had no significant difference between group N and the controls. The PVd and DSVR were significantly lower in patients of group R than those in patients of group N and the controls. Conclusions Monitoring of the distal LAD flow velocity by TTCDE was useful in the noninvasive assessment of re-stenosis after stent intervention for the LAD lesions.