安定労作狭心症患者の運動耐容能規定因子—冠動脈病変と冠血流予備能

Coronary Flow Reserve and Stenosis as the Determinant of Exercise Capacity in Patients with Stable Effort Angina

　カテーテル先端型ドプラ血流速計を用いて左前下行枝一枝病変の安定労作狭心症33症例の冠血流予備能（coronary flow reserve,CFR）を評価した．冠動脈造影に伴う造影剤注入による“いわゆる反応性充血様変化”の程度をその指標とした．一部の症例で経皮的冠動脈形成術前後の冠血流予備能の変化を検討した．

　CFRとトレッドミル運動負荷心電図法による運動耐容能の間には良い相関が得られた．理論的予測のごとく労作狭心症例の運動耐容能はCFRに規定された．造影法による冠狭窄の程度とCFRの間には良い相関がなかった．冠狭窄度と運動耐容能との間にも関連はなかった．しかし冠動脈形成術により冠狭窄を解除するとCFRは増加した．

The coronary flow reserve was evaluated in 33 patients with stable effort angina and single vessel disease of the left anterior descending artery. We used a catheter-tip Doppler flow probe with injection of contrast media to the vessel in order to induce so-called reactive hyperemia. The reactive change was used as an index of the flow reserve of the coronary artery. In 15 patients out of 33, PTCA was performed and the change in the coronary flow reserve was evaluated.

There was a good correlation between the coronary flow reserve and the exercise capacity in the treadmill ECG exercise test.