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目的:探讨冠状动脉慢血流现象的临床及近期预后价值。方法:通过矫正的TIMI血流分级方法,评价冠状动脉血流速度和远端血流灌注。对37例正常血流者和35例无冠状动脉狭窄性病变而冠状动脉慢血流者行次级量平板运动试验及心脏超声左室射血分数(LVEF)测定,并随访1年,观察近期预后。结果:冠状动脉慢血流组平板运动试验阳性率明显高于正常血流组(71.4%∶13.5%,P<0.01),而平板运动耐量时间明显低于正常血流组[(5.32±4.38)∶(10.58±5.67)min,P<0.01)];2组LVEF差异无统计学意义;随访1年发现冠状动脉慢血流组中10例反复心绞痛发作、1例发生急性下壁心肌梗死,无心脏性猝死发生。结论:冠状动脉慢血流现象与运动耐量降低、心绞痛发作有关,应引起临床重视。
Objective: To investigate the clinical and short-term prognostic value of slow blood flow in coronary arteries. METHODS: Coronary flow velocities and distal perfusion were assessed by a modified TIMI flow classification. 37 patients with normal blood flow and 35 patients with coronary artery stenosis without coronary artery stenosis underwent secondary quantitative treadmill exercise test and left ventricular ejection fraction (LVEF), and follow-up for 1 year to observe the recent Prognosis. Results: The positive rate of treadmill exercise test in patients with chronic low-flow coronary artery was significantly higher than that in normal blood flow group (71.4% vs 13.5%, P <0.01), while the treadmill exercise time was significantly lower than that in normal blood flow group [(5.32 ± 4.38) (10.58 ± 5.67) min, P <0.01). There was no significant difference in LVEF between the two groups. One-year follow-up found that 10 cases of recurrent angina pectoris occurred in the slow-flow coronary artery group and 1 case had acute inferior myocardial infarction Sudden cardiac death. Conclusion: The phenomenon of slow blood flow in coronary arteries is associated with decreased exercise tolerance and angina pectoris, which should be paid more attention to.