论文部分内容阅读
目的 :分析在肥厚型心肌病患者冠状动脉 (冠脉 )肌桥的临床及造影特点。 方法 :肥厚型心肌病患者 90例 ,所有患者通过采用Judkins法接受选择性冠脉造影及左心室造影检查 ,每支冠脉均经多体位投照 ,以收缩期冠脉管腔直径压缩至少 5 0 %或出现吸吮效应作为确定肌桥存在的证据 ,同时以至少一支冠脉管腔狭窄≥ 5 0 %作为有意义狭窄。 结果 :90例患者中发现肌桥 19例 (2 1 1% ) ,其造影特点显示 ①按压缩部位分类 :前降支中段 14例 (74% ) ,前降支中远段 1例 (5 % ) ,前降支弥漫性压缩 1例 (5 % ) ,间隔支 2例 (11% ) ,前降支中远段加对角支 1例 (5 % ) ;②按压缩程度分类 :收缩期管腔直径压缩 <5 0 %者 4例 (2 1% ) ,≥ 5 0 %～≤ 80 %者 11例 (5 8% ) ,>80 %～≤ 90 %者 2例(11% ) ,>90 %～ 10 0 %者 2例 (11% ) ;③左心室造影显示异常者 13例 (68% ) ,正常者 6例 (3 2 % )。此外经造影证实合并冠心病者 2例 (11% )。 结论 :在肥厚型心肌病中肌桥为常见征象 ,明显高于其他患者 ,故临床应予以重视。
Objective: To analyze the clinical and angiographic features of coronary artery (coronary) muscle bridge in patients with hypertrophic cardiomyopathy. Methods: Ninety patients with hypertrophic cardiomyopathy were enrolled. All patients underwent selective coronary angiography and left ventricular angiography with the Judkins method. Each coronary artery was surgically treated with multi-position projection and the systolic coronary artery lumen diameter was reduced by at least 5 0% or sucking effect as evidence for the presence of a muscular bridge, with at least one coronary stenosis ≥ 50% as a meaningful stenosis. Results: 19 cases (21.1%) of muscle bridge were found in 90 patients. According to the angiographic features, 14 cases (74%) in the middle part of anterior descending artery and 1 case (5% , Diffuse compression of anterior descending artery in 1 case (5%), interval in 2 cases (11%), anterior descending branch plus diagonal branch in 1 case (5%); ② according to the compression degree classification: systolic lumen diameter Compression was less than 50% in 4 cases (21%), ≥50% ≤80% in 11 cases (58%),> 80% ≤90% in 2 cases (11% 2 cases (10%) were found in 2 cases (11%); 13 cases (68%) showed abnormal left ventricular angiography and 6 cases (32%) were normal. In addition, angiography confirmed coronary heart disease in 2 patients (11%). Conclusion: Myocardial bridge is a common sign in hypertrophic cardiomyopathy, which is obviously higher than other patients, so it should be taken seriously in clinical practice.