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題名 | The Relation between Thickened Aortic Valve and Coronary Artery Disease=主動脈瓣變厚與冠狀動脈性心臟病的關係 |
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作者 | 林少琳; 劉俊鵬; 陳宗瀛; 葛魯蘋; 姜洪霆; | 書刊名 | 中華醫學雜誌 |
卷期 | 60:2 1997.08[民86.08] |
頁次 | 頁92-97 |
分類號 | 415.384 |
關鍵詞 | 冠狀動脈性心臟病; 超音波心圖; 主動脈瓣增厚; Coronary artery disease; Echocardiography; Thickened aortic valve; |
語文 | 英文(English) |
中文摘要 | 背景:主動脈瓣變厚與同側冠狀動脈狹窄之的相關性過去並沒有報告,本文是想探討是否左側主動脈瓣變厚將合併有左側之冠狀動脈狹窄,同樣的相關性也發生在右側之主動脈瓣。 方法:對420位連續性病人分別做雙面超音波心圖及心導管檢查,此外對160位在超音波心圖上只有一個主動脈瓣變厚的病人也加以分析,以觀察是否主動脈瓣變厚及冠狀動脈狹窄之間有某種關連性。主動脈變厚的定義是瓣膜厚度比主動脈壁之厚比值≧l,冠狀動脈狹窄之定義是左總(Left main)冠狀動脈狹窄程度大於50%,或其他冠狀動脈狹窄程度大於70%。 結果:有主動脈瓣變厚之病人合併有冠狀動脈性心臟病之比例(89/132;67.4%)比沒有變厚之病人(141/128;49%)要高得多(p < 0.05),在主動脈瓣變厚之病人中,合併有冠狀動脈性心臟病之比率,在50歲的這組佔了45.5%,在60歲組佔60%,70歲組佔69.6%,80歲組佔74.1%,這種隨著年齡老化而有較高的冠狀動脈性心臟病的現象,在主動脈瓣膜變厚及不厚的病人都有這種特性。在106位具有一個主動脈瓣變厚的病人中,有30位(28.3%)有左冠狀動脈瓣變厚,其中有左側冠狀動脈狹窄者有12位(40%),右側冠狀動脈狹窄者有3位(10%),有7位(23.3%)沒有冠狀動脈狹窄。在34位有右主動脈瓣變厚之病人中,左側冠狀動脈狹窄者有13位(38.2%),有右冠狀動脈狹窄者有3位(8.8%),沒有狹窄有5位(14.7%)。結果發現瓣膜變厚與同側冠狀動脈狹窄之間並沒有相關性(X =0.06,p=0.96)。 結論:主動脈瓣變厚者有較高的比例合併有冠狀動脈狹窄,隨著年齡老化會合併有較多的冠狀動脈性心臟病,瓣膜變厚與同側冠狀動脈狹窄之間並沒有相關性。 |
英文摘要 | Background: The relationship between the site of aortic valve thickening and ipsilateral coronary artery stenosis has not been reported previously. This study was undertaken to test the hypothesis that left-sided coronary cusp thickening may be associated with a left-sided coronary artery stenosis, and also as would be in the right-sided relationship. Methods: Two-dimensional echocardiography and cardiac catheterization were used to evaluate 420 consecutive patients. One hundred and six patients who had echocardiographic evidence of a single aortic valve thickening were studied to determine whether there was a relation between the coronary artery stenosis and the aortic valve thickening at the same side. Thickened aortic valve was defined as an aortic valve thickness to aortic wall thickness ratio >= 1.0. Coronary artery disease (CAD) was defined as a > 50% luminal diameter narrowing of the left main coronary artery or a > 70% luminal diameter narrowing of the coronary artery other than the left main coronary artery. Results: Patients with a thickened aortic valve had a greater incidence of CAD (89/132, 67.4%) than those without (141/288, 49.0%) (p < 0.05). In patients with thickened aortic valves, the incidence of CAD was 45.5% in the fifth decade, 60% in the sixth decade, 69.6% in the seventh decade and 74.1% in the eighth decade. Progressive increase of the incidence of CAD was not found in patients without a thickened aortic valve. In the 106 cases with a single aortic valve thickening, 30 patients (28.3%) had a left coronary cusp thickening; 12 of them (40%) had a left-sided coronary artery stenosis, 3 patients (10%) had right coronary artery stenosis and 7 patients (23.3%) had no coronary artery stenosis. In the 34 patients with right coronary cusp thickening, the stenosis occurred at the left coronary artery in 13 patients (38.2%), at the right coronary artery in 3 patients (8.8%) and with normal coronary artery in 5 patients (14.7%). This finding did not support the relationship between thickened aortic valve and coronary artery disease at the same side (x2 = 0.06, p = 0.96). Conclusions: There was a significantly greater incidence of CAD in patients with a thickened aortic valve than in those without. The incidence of CAD in patients with thickened aortic valves increased with age. There was no direct relationship observed between the site of aortic valve thickening and ipsilateral coronary artery stenosis. |
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