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脳死ブタにおける心筋機能不全と関連した機能性心筋不全の証拠
C Seguin1, Y Devaux, S Grosjean
1Laboratoire de Chirurgie Expérimentale, Faculté de Médecine de Nancy, Université Henri Poincaré, Nancy I, France.
Circulation
|September 25, 2001
まとめ
脳死は,酸素の供給・需要の不均衡による心筋機能障害を引き起こし,その証拠は乳酸とアデノシンの増加である. ラベタロール治療は,この機能不全を緩和し,豚の有酸素代謝を維持しました.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- 生理学 生理学とは
背景:
- 脳死後の心臓機能不全は認められているが,よく理解されていない.
- 心筋力衰退は,脳死後の心臓機能不全に寄与するメカニズムである.
研究 の 目的:
- 心筋の酸素供給と需要の不均衡が脳死豚の心臓機能不全を引き起こすかどうかを調査する.
主な方法:
- 心臓マイクロダイアリスは,脳死豚およびラベタロールで治療された豚のインタースティシャル心筋乳酸およびアデノシンを測定するために使用されました.
- 心拍数,心臓の出力,冠動脈の血流を含む血液動力学的パラメータは,継続的にモニタリングされました.
主要な成果:
- 脳死ブタは,心拍数,心電量,冠動脈血流の増加を示したが,冠動脈血流の限られた増加は,機能性心筋不全症につながった.
- 心筋乳酸酸とアデノシン濃度の著しく上昇は,脳死豚のイシュケミアを確認した.
- ラベタロール治療は心臓機能と有酸素代謝を安定させ,心拍数とアデノシンが適度に上昇しただけであった.
結論:
- 脳死は,腸内アデノシンと乳酸の増加に関連した心筋機能障害を誘発する.
- この機能障害は,心筋の酸素消費と供給の不均衡から生じるようです.
- ラベタロールはこれらの効果を弱め,脳死後の心臓機能不全の管理における潜在的な役割を示唆した.
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