比較的老年者の冠動脈病変と心機能特性に関する臨床的研究

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  • Analysis of Coronary Arteriography and Left Ventriculography in Aged, 119 Patients
  • ヒカクテキ ロウネンシャ ノ カンドウミャク ビョウヘン ト シンキノウ トク

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The extent and severity of coronary arteriographic and left ventriculographic findings were analyzed in aged patients. 119 patients over 60 years old (96 male and 23 female) were selected out of 900 patients studied in this laboratory. The average age was 64 years, range 60 and 78 years. 100 patients (84%) had the clinical diagnosis of coronary artery disease (CAD), 15 had valvular disease and 5 had cardiomyopathy.<br>In 100 patients with CAD (83 male, 17 female), 37 patients (37%) developed significant stenosis of 3 or 4 major coronary artery (94.5% male, 5.5% female) and 24 patients (24%) had obstractions of 2 vessels and 16 (16%) had a single vessel disease and 10 patients had lesions less than 50% narrowing of lumen diameter, while 4 patients (4%) exhibited coronary spasm during the procedure. The remaining 9 (4 male, 5 female) had normal arteriogram. The anterior desending was affected in 58 patients, of which 33 patients presented complete occlusion. The right coronary artery was involved in 32 patients and 26 patients of these presented complete occlusion. The main left coronary was involved in 13 patients (13%). Moreover, 57 patients (57%) had major ventricular aneurysm or akinesis is left ventriculography, which resulted in impairment of left ventricular function. The risk of CAD appeared to rise in proportion to the high level of serum triglyceride and the low level of HDL-cholesterol concentration. The extent and severity of coronary artery seemed to be related to the exsistence of hypertention, glucose intolerance and cigarettes habit. These results indicate that coronary artery is affected by the atherosclerotic process as the individual becomes older, which results in the extensive myocardial ischemia and severe pump failure. In conclusion, it is necessary to correct or protect these coronary risk factors for the treatment of CAD in aged patients.

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