慢性完全闭塞病变侧支循环对供血动脉狭窄的生理学影响1例
陈帅,龚冬火,沈迎,涂圣贤,丁风华,沈卫峰
摘要(Abstract):
<正>1临床资料患者男,61岁。因"活动后胸闷6个月,加重1周"入院。患者近6个月来活动后出现胸闷,发作时无汗出、濒死感,每次发作持续数分钟不等,含服硝酸甘油后可好转。病程中无心悸、咳血及夜间阵发性呼吸困难,双下肢无水肿,未予系统治疗。近1周来上述症状加重,每次持续时间较前延长,遂于2017年7月24日来上海交通大学医学院附属瑞金医院就诊。既往有高血压病史20余年,长期服用硝苯地平30 mg、每日1次,
关键词(KeyWords): 慢性完全闭塞病变;血流储备分数;侧支循环
基金项目(Foundation): 国家自然科学基金(81470469、81770447);; 上海市科委课题(15411963700);; 上海交通大学医学院高峰高原计划(20181801)
作者(Author): 陈帅,龚冬火,沈迎,涂圣贤,丁风华,沈卫峰
参考文献(References):
- [1]冠状动脉血流储备分数临床应用专家共识专家组.冠状动脉血流储备分数临床应用专家共识.中华心血管病杂志, 2016, 44(4):292-297.
- [2]Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J, 2018.[Epub ahead of print].
- [3]Kurisu S, Mitsuba N, Ishibashi K, et al. A pitfall of fractional flow reserve associated with the presence of collateral circulation. Intern Med, 2011, 50(22):2811-2813.
- [4]Melikian N, Cuisset T, Hamilos M, et al. Fractional flow reserve--the influence of the collateral circulation. Int J Cardiol, 2009, 132(3):e109-e110.
- [5]Ladwiniec A, Cunnington MS, Rossington J, et al. Collateral donor artery physiology and the influence of a chronic total occlusion on fractional flow reserve. Circ Cardiovasc Interv, 2015, 8(4):e002219.
- [6]Mohdnazri SR, Karamasis GV, Al-Janabi F, et al. The impact of coronary chronic total occlusion percutaneous coronary intervention upon donor vessel fractional flow reserve and instantaneous wavefree ratio:implications for physiology-guided PCI in patients with CTO. Catheter Cardiovasc Interv, 2018, 92(3):E139-E148.
- [7]Tigen K, Durmu?E, Sari I. Recanalization of a total occlusion with marked retrograde collateral supply:impact of collateral circulation on fractional flow reserve measurements of donor artery. J Invasive Cardiol, 2014, 26(6):E70-E75.