METHOD FOR DIAGNOSING LIMITATION OF LOCAL RESERVE IN KINKING CORONARY ARTERY IN PATIENTS WITH ISCHEMIC HEART DISEASE AND CORONARY SYNDROME X

摘要

A method for diagnosing the limitation of the local reserve in the kinking coronary artery in the patients with ischemic heart disease and coronary syndrome X provides for calculating the relative loss of the blood flow. The own physico-mathematical model allows for calculating the loss of the blood flow in the kinking coronary artery relative to the straight area of the coronary artery. The coronary syndrome X is diagnosed as follows: the objective features of the myocardial ischemia, the absence of atherosclerotic or other stenosis, the presence of the kinking area in the coronary artery. The axis length of the kinking areas is estimated by the approximation of irregular sinusoid. Then, the straight area of the coronary artery of the identical length is found out. The time of blood flow in the kinking and normal areas is compared to determine the relative loss of the blood flow. The hemodynamic significance of the blood flow loss is calculated in 25 % of pressure difference in the artery, the latter being hemodynamically significant according to the findings of the invasive technique for measuring the regional blood flow reserve (≈40 %). In other words, the hemodynamically significant kinking of the coronary artery is defined as that decreasing the blood flow loss by at least 40 % as compared with blood flow in the straight area of the artery, the other conditions being similar (arterial blood pressure, heart rate, cardiac output, blood viscosity, total peripheral vascular resistance). Such hemodynamically significant changes in blood flow loss limit the local reserve in the kinking coronary artery in the patients with ischemic heart disease and coronary syndrome X.