临床使用的冠状动脉血液动力学指数的生理基础
Jos A E Spaan1, Jan J Piek, Julien I E Hoffman
1Department of Medical Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. j.a.spaan@amc.uva.nl
Circulation
|January 25, 2006
概括
冠状动脉循环的简化模型通常是不准确的. 这份综述强调了冠状动脉血管的非线性性质,并建议结合压力和流量测量以进行更好的生理学研究.
科学领域:
- 心血管生理学心血管生理学
- 血液动力学 血液动力学
- 生物医学工程 生物医学工程
背景情况:
- 临床上使用的血液动力学指数,如分数流量储备,依赖于简化冠状动脉循环模型.
- 这些模型通常假设心肌阻力独立于心脏收缩和驱动压力,这并不总是准确的.
研究的目的:
- 审查冠状动脉循环的非线性特征.
- 检查血管延伸性,压力-流量关系和附带流量对血液动力学指数的影响.
主要方法:
- 对冠状动脉生理学和血液动力学现有文献的综述.
- 在冠状动脉系统中分析压力流动力学.
- 评估阻力容器延伸性和附带流量的作用.
主要成果:
- 冠状动脉系统本质上是非线性的,因为阻力血管的变化取决于压力和功能.
- 附带流量对于解释压力和流量衍生的微分流量储备之间的差异是不必要的.
- 附带流量仅在低距离压力下显著影响测量.
结论:
- 传统的血液动力学指数对于临床决策仍然很有价值.
- 建议在未来的冠状动脉生理学临床研究中对冠状动脉流量 (或速度) 和压力的联合测量.
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