RESUMO
The segmental ventricular function of 76 patients with total occlusion of the left anterior descending coronary artery (LAD) was analyzed to establish the relationship between ventricular function and the presence and angiographic appearance of the collateral circulation. The relationship between function and collateral supply was found to be significant (P less than .01). The only angiographic feature of the collateral vasculature that was associated with preserved function was the caliber of the distal LAD. Wide-caliber vessels were more likely to be associated with preserved ventricular function than thin vessels (P less than .01). In contrast, both rapidly filling collateral arteries and slow filling vessels were associated with preserved ventricular function. Collateral supply maintenance was significantly associated with preserved ventricular function, even when the collaterals arose from stenotic coronary arteries. Furthermore, despite marked differences in ventricular function between the base and apex of the heart, there was a true relationship between preserved ventricular function and the presence of collateral vessels for all segments of the anterior wall. These findings may be relevant to clinical decision making and to proper interpretation of studies of ventricular function following LAD occlusion.
Assuntos
Circulação Colateral , Angiografia Coronária , Circulação Coronária , Doença das Coronárias/fisiopatologia , Contração Miocárdica , Angiografia , Vasos Coronários/fisiopatologia , HumanosRESUMO
Intravenous fat emulsions have been advocated as acceptable alternatives to hyperosmolar glucose solutions in parenteral nutrition. The ability of a fat emulsion (soy bean oil suspended in glycerol) to produce nitrogen sparing in the absence of nitrogen intake was examined in normal man. The protein conservation obtained by the fat emulsion can be duplicated by the infusion of glycerol alone in the same amount as that available from the fat emulsion.