Predictors of Brachial Artery Spasm during Transradial Cardiac Catheterization

在經橈動脈心導管中發生肱動脈痙攣之預測因子

林岳志(Yueh-Juh Lin) ； 劉言彬(Yen-Bin Liu) ； 朱景祺(Ching-Chi Chu) ； 蔡忠文(Chung-Wen Tsai)

《Acta Cardiologica Sinica》 22卷3期 (2006/09) Pp. 134-141

摘要

背景　肱動脈痙攣可能在經撓動脈心導管檢查中發生。本研究目的在檢驗經撓動脈心導管檢查後肱動脈痙攣與冠狀動脈病之關係。
方法　本計畫包括241位病患為了診斷冠狀動脈病接受經撓動脈心導管檢查。我們在心導管檢查後進行肱動脈血管攝影以確認肱動脈痙攣。在評估中包括年齡、性別、冠狀動脈病危險因子、臨床、血行動力學以及血管攝影相關變數。
結果　在本研究的241位病患中，99(41%)位有冠狀動脈病，但其他病患則無。有冠狀動脈病之病患中9(9.09%)位有肱動脈痙攣，而非冠狀動脈病之病患中34(23.94%) 位有肱動脈痙攣(p=0.001)。在單變數分析中，與肱動脈痙攣有關因子包括心跳速率、肱動脈直徑和冠狀動脈病。在多變數分析中，經撓動脈心導管檢查後肱動脈痙攣的獨立預測因子包括無冠狀動脈病(p=0.019)與肱動脈直徑(p=0.005)。有冠狀動脈病患者在經撓動脈心導管檢查後較不易發生肱動脈痙攣。
結論　我們認為肱動脈痙攣並不影響冠狀動脈病患之經撓動脈心導管檢查。小肱動脈與無冠狀動脈病可預測經撓動脈心導管檢查中發生之肱動脈痙攣。

關鍵字

血管痙攣 ； 冠狀動脈病 ； 內皮細胞功能失常 ； 心導管

並列摘要

Background: Brachial artery spasms may occur during transradial cardiac catheterization. The purpose of this study was to examine the relationship between brachial artery spasms after transradial cardiac catheterization and coronary artery disease.
Methods: Two hundred and forty-one patients who received transradial cardiac catheterization for diagnosis of coronary artery disease were enrolled in this study. Brachial artery angiography was performed after cardiac catheterization in order to document brachial artery spasms. Age, sex, coronary risk factors, clinical, hemodynamic, and angiographic characteristics were included in our assessment.
Results: In 241 patients enrolled, 99 patients had coronary artery disease and the others did not. The rate of brachial artery spasm was 9.09% (9/99) in patients with coronary artery disease and 23.94% (34/142) in patients without coronary artery disease (p=0.001). In univariate analysis, factors associated with brachial artery spasms included heart rate, diameter of brachial artery and coronary artery disease. In multivariate analysis, the absence of coronary artery disease (p=0.019) and the diameter of brachial artery (p=0.005) were the independent predictors of brachial
artery spasms after transradial cardiac catheterization. The patient with coronary artery disease was less likely to have brachial artery spasms after transradial cardiac catheterization.
Conclusion: Our study suggests that brachial artery spasms do not affect the feasibility of transradial coronary intervention in patients with coronary artery disease. Furthermore, small brachial artery and the absence of coronary artery disease predict brachial artery spasm during transradial cardiac catheterization.

並列關鍵字

Vasospasm ； Coronary artery disease ； Endothelial dysfunction ； Cardiac catheterization