Myocardial ischemia threshold heart rate in patients with coronary myocardial bridge

Xiong haigang; Pang guangyu; Chen huashan; Yu feihu; Yang lei; Liu zuqiu

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Myocardial ischemia threshold heart rate in patients with coronary myocardial bridge

更新时间：2025-10-15

- Myocardial ischemia threshold heart rate in patients with coronary myocardial bridge
- Issue 3, Pages: 178-180(2021)
- 作者机构：
  
  解放军第906医院
- 作者简介：
- 基金信息：
- DOI：
  CLC： R541.7
- Published：2021
- 稿件说明：
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Xiong haigang, Pang guangyu, Chen huashan, et al. Myocardial ischemia threshold heart rate in patients with coronary myocardial bridge[J]. 2021, (3): 178-180.
DOI：

Xiong haigang, Pang guangyu, Chen huashan, et al. Myocardial ischemia threshold heart rate in patients with coronary myocardial bridge[J]. 2021, (3): 178-180. DOI：

摘要

目的分析冠状动脉心肌桥在心脏收缩末期不同的冠脉狭窄率引起心肌缺血的阈值心率。方法我院自2015年1月1日至2016年12月30日行冠状动脉造影术(CAG)术765例患者

发现冠状动脉心肌桥25例

去除3例肌桥合并阻塞性冠脉病变

22例冠状动脉心肌桥患者中

按照定量冠状动脉造影分析法(QCA法)

将心脏收缩末期冠脉狭窄率分为三组

A组冠脉狭窄率≤50%

50%<B组冠脉狭窄率≤75%

75%<C组冠脉狭窄率≤99%;22例患者全部行24小时动态心电图检查

以"三个一"做为心肌缺血的标准

即以R波为主的导联ST段呈水平或下斜型压低≥0.1mV

每次持续时间≥1分钟

相邻两次间隔至少1分钟

观察不同组别引起心肌缺血时阈心率。结果 A组5例冠脉狭窄率≤50%

基础心率平均为68±0.30次/分

引起心肌缺血的平均心率103±1.50次/分;50%<B组2例冠脉狭窄≤75%

基础心率平均为70±1.10次/分

引起心肌缺血的平均心率95±2.40次/分;75%<C组15例冠脉狭窄≤99%

基础心率平均为70±2.30次/分

引起心肌缺血的平均心率86±1.60次/分;经检验

A、B、C三组基础心率无显著性差异(p>0.05);引起心肌缺血的平均心率A组与C组比较

有显著性差异(p<0.05);A组与B组比较、B组与C组比较

无显著性差异(p>0.05)。结论冠状动脉心肌桥患者

随着心脏收缩末期冠脉狭窄率增加

引起心肌缺血的阈值心率下降

狭窄率越明显

引起心肌缺血的阈值心率越慢

提示冠脉血流储备下降。

Abstract

Objective To analyze heart rate threshold of myocardial ischemia due to different coronary artery stenosis rate on cardiac end-systolic in patients with coronary myocardial bridge. Methods A total of 765 patients coronary angiography（CAG） were performed from January 2015 to December 2016

25 patients were founded coronary myocardial bridge

removed 3 patients with coronary myocardial bridge combine coronary artery occlusive disease. 22 patients with coronary myocardial bridge were divided into 3 groups according to coronary artery stenosis rate on cardiac end-systolic by quantitative coronary angiography（QCA）

A group coronary artery stenosis rate≤50%

50%<B group coronary artery stenosis rate ≤75%

75%< C group coronary artery stenosis rate ≤99%; 22 patients performed ambulatory Holter electrocardiogram

according to diagnostic criteria of myocardial ischemia

R-wave lead ST segment horizontal depression or downhill depression ≥0.1 mV

duration of each time ≥1 minute

two adjacent intervals at least 1 minute

observe heart rate threshold of myocardial ischemia in different groups. Results A group 5 patients coronary artery stenosis rate ≤50%

basic mean heart rate was 68±0.30 beat per minute

mean heart rate that lead to myocardial ischemia was 103 ±1.50 beat per minute; 50%< B group 2 patients coronary artery stenosis rate ≤75%

basic mean heart rate was 70±1.10 beat per minute

mean heart rate that lead to myocardial ischemia was 95±2.40 beat per minute; 75%< C group 15 patients coronary artery stenosis rate≤99%

basic mean heart rate was 70±2.30 beat per minute

mean heart rate that lead to myocardial ischemia was 86±1.60 beat per minute; statistically test

the difference of basic mean heart rate among ABC groups was not significant（p >0.05）; mean heart rate that lead to myocardial ischemia between A group and C group was statistically significant（p <0.05）; mean heart rate that lead to myocardial ischemia between A group and B group was not significant（p>0.05）; mean heart rate that lead to myocardial ischemia between B group and C group was not significant（p >0.05）; Conclusions Heart rate threshold of myocardial ischemia of patients with coronary myocardial bridge decreased along with coronary artery stenosis rate increased on cardiac end-systolic; the stenosis rate was more obvious

heart rate threshold of myocardial ischemia was more slow

it show that coronary flow reserve decreased.

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