王冬梅,韩雅玲,臧红云,于海波,王守力,荆全民,王祖禄

• 1:解放军沈阳军区总医院心血管内科

摘要(Abstract)：

目的了解冠状静脉解剖形态,为心脏再同步治疗中成功植入左室电极提供依据。方法住院患者113例,男93例,女20例,平均年龄63.5±10.6岁。所有患者均行冠状静脉造影。结果113例中有1支以上血管异常者为97例(85.84%);静脉缺如25例(22.13%),静脉细小36例(31.86%),静脉扭曲19例(16.81%),静脉狭窄5例(4.42%),冠状静脉窦肌桥9例(7.96%)。2例心侧静脉近段发出二级分支,5例心后侧静脉近段发出二级分支。冠状静脉变异与性别无明显关系。非缺血性心肌病心侧静脉和心后侧静脉异常总数明显多于缺血性心肌病(91.25%比72.72%,P<0.05)。冠状静脉窦肌桥均发生在非缺血性心肌病,占11.25%。结论心力衰竭患者冠状静脉解剖具有很大变异性。冠状静脉一级和二级分支的位置、大小等解剖差异与性别、冠状动脉病变或心肌梗死区域无关,非缺血性心肌病的血管变异比例更高。

关键词(KeyWords)： 心力衰竭,充血性;心脏起搏,人工;冠状血管

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王冬梅,韩雅玲,臧红云,于海波,王守力,荆全民,王祖禄

参考文献(References)：

• [1]Mao S,Shinbane JS,Girsky MJ,et al.Coronary venous imaging with electron beam computed tomographic angiography:three-di-mensional mapping and relationship with coronary arteries.Am Heart J,2005,150:315-322.
• [2]Schaffler GJ,Groell R,Peichel KH,et al.Imaging the coronary venous drainage system using electron-beam CT.Surg Radiol Anat,2000,22:35-39
• [3]Gerber TC,Sheedy PF,Bell MR,et al.Evaluation of the coro-nary venous system using electron beam computed tomography.Int J Cardiovasc Imag,2001,17:65-75
• [4]Gilard M,Mansourati J,Etienne Y,et al.Angiographic anatomy of the coronary sinus and its tributaries.Pacing Clin Electrophys-iol,1998,21:2280-2284
• [5]王方正,张澍,黄德嘉,等.心脏再同步治疗慢性心力衰竭的建议.中华心律失常杂志,2006,10;90.
• [6]王冬梅,韩雅玲,臧红云,等.右室心尖或右室间隔部起搏对再同步治疗的影响.中华心血管病杂志,2008,36:831-833.
• [7]Heist EK,Fan D,Mela T,et al.Radiographic left ventricular-right ventricular inter-Lead distance predicts the acute hemody-namic response to cardiac resynchronization therapy.Am J Cardi-ol,2005,96:685-690.
• [8]Singh JP,Fan D,Heist EK,et al.Left ventricular lead electri-cal delay predicts response to cardiac resynchronization therapy.Heart Rhythm,2006,3:1285-1292.
• [9]Blendea D,Shah RV,Auricchio A,et al.Variability of coronary venous anatomy in patients undergoing cardiac resynchronization therapy:A high-speed rotational venographystudy.Heart-Rhythm,2007,4:1155-1116.
• [10]von Ludinghausen M.The venous drainage of the human myocar-dium.Adv Anat Embryol Cell Biol,2003,168:1-10.
• [11]Ortale JR,Gabriel EA,Iost C,et al.The anatomy of the coro-nary sinus and its tributaries.Surg Radiol Anat,2001;23:15-21.
• [12]Hare JM,Walford GD,Hruban RH,et al.Ischemic cardiomyop-athy:endomyocardial biopsy and ventriculographic evaluation of patients with congestive heart failure,dilated cardiomyopathy and coronary artery disease.J Am Coll Cardiol,1992,20:1318-1325.