CAJ | 학술논문

目的：用冠状动脉内多普勒血流速度描记的方法评价左室肥厚对冠脉血流速度及血流储备的影响。方法：研究对象为41例冠脉造影正常的患者。分三组：甲组为11例无冠脉微血管病变基础者，男9例，女2例，年龄(48.91±7.18)岁，共27支冠脉，包括前降支10支，回旋支6支，右冠脉10支，对角支1支。乙组为16例有冠脉微血管病变基础但无左室肥厚者，男9例，女7例，年龄(56.63±9.83)岁，共41支冠脉，包括前降支16支，回旋支11支，右冠脉13支，对角支1支。丙组为14例左室肥厚者，男9例，女5例，年龄(60.14±8.98)岁，共28支冠脉，包括前降支9支，回旋支7支，右冠脉12支。用Cardiometrics Flomap Ⅱ仪器和0.014英寸多普勒钢丝测量：远端平均峰速(APV)、舒张期与收缩期流速比(D/SVR)、血流储备(CFR)和近端与远端流速比(P/DVR)。左室心肌重量用二维超声心动图法测定。结果：与甲组相比，丙组冠脉远端基础状态APV显著较高(P＝0.0023)，而冠脉远端CFR显著较低(P＝0.031)。丙组冠脉远端CFR亦较无左室肥厚的乙组低(P ＝0.034)。同时左室心肌重量与左冠脉CFR呈负相关(r＝－0.36，P＜0.0 5)。乙组CFR虽较甲组低，但差别无显著意义(P＞0.05)。结论：左室肥厚引起基础APV升高，是造成冠脉血流储备降低的重要原因之一。
목적：용관상동맥내다보륵혈류속도묘기적 방법평개좌실비후대관맥혈류속도급혈류저비적영향。방법：연구대상위41례관맥조영정상적환자。분삼조：갑조위11례무관맥미 혈관병변기출자，남9례，녀2례，년령(48.91±7.18)세，공27지관맥，포괄전강지10지 ，회선지6지，우관맥10지，대각지1지。을조위16례유관맥미혈관병변기출단무좌실비후자 ，남9례，녀7례，년령(56.63±9.83)세，공41지관맥，포괄전강지16지，회선지11지， 우관맥13지，대각지1지。병조위14례좌실비후자，남9례，녀5례，년령(60.14±8.98)세 ，공28지관맥，포괄전강지9지，회선지7지，우관맥12지。용Cardiometrics Flomap Ⅱ의 기화0.014영촌다보륵강사측량：원단평균봉속(APV)、서장기여수축기류속비(D/SVR)、혈 류저비(CFR)화근단여원단류속비(P/DVR)。좌실심기중량용이유초성심동도법측정。결과：여갑조상비，병조관맥원단기출상태APV현저교고(P＝0.0023)， 이관맥원단CFR현저교저(P＝0.031)。병조관맥원단CFR역교무좌실비후적을조저(P ＝0.034)。동시좌실심기중량여좌관맥CFR정부상관(r＝－0.36，P＜0.0 5)。을조CFR수교갑조저，단차별무현저의의(P＞0.05)。결론：좌실비후인기기출APV승고，시조성관맥혈류저비강저적중요원인지일。
Objective:The purpose of this study was to evaluate the effect of left ventricular hypertrophy on coronary flow reserve(CFR ).Methods：Forty one angiographically normal patients were studied by using Cardiometrics Flomap Ⅱ Ultrasound Instrument and 0.014 inch f lowire.The patients were divided into three groups:group A,11 patients(27 arteri es)without underlying diseases of coronary microvasuclar lesions;group B,16 pati ents(41 arteries)with underlying diseases of coronary microvascular lesions but without left ventricular hypertrophy;group C,14 patients (28 arteries)with under lying diseases of coronary microvascular lesions and left ventriuclar hypertroph y.The flow velocity measurements included average peak velocity(APV),diastolic/ systolic velocity ratio(D/SVR),coromary flow reserve(CFR)and proximal/distal vel ocity ratio(P/DVR).Results:The distal baseline APV of group C was significantly h igher than that of group A(P＝0.0023).The distal CFR in group C was remarka bly lower than that of group A(P＝0.031) and group B(P＝0.034).CFR of left coronary arteries in all groups was inversely correlated with left ventricu lar myocardial mass(r＝－0.36，P＜0.05).There were no statistical diff erences between all flow velocity measurements of Group A and B.Conclusions:Left ventricular hypertrophy is one of the most im portant reasons of decreased coronary flow reserve.