冠動脈の周期的な流れの変動 "前提条件" 発血性心筋梗塞 心筋梗塞
M Ovize1, R A Kloner, S L Hale
1Heart Institute Hospital of the Good Samaritan, Los Angeles, CA 90017.
Circulation
|February 1, 1992
まとめ
自発的な冠動脈血栓形成は,心臓を予備状態にし,心臓発作の大きさを機械的予備状態に似たように減らすことができます. サイクルフロー・バリエーション (CFV) のこの保護効果は,機械的な予備条件付けとは異なり,より長いイシュケミアの後でさえも持続します.
科学分野:
- 心血管科学 心血管科学
- 発血性心臓病の研究について
- 心筋膜の保護メカニズム
背景:
- 短時間の冠動脈閉塞による機械的な予備条件付けにより,心臓発作のサイズが小さくなります.
- 不安定性 angina のように,自発的な一時性缺血の心臓保護効果は不明です.
研究 の 目的:
- 犬のモデルで,自発的血栓性エピソードが心臓発作のサイズを制限し,持続したイシュケミアと再注射後の収縮機能を保存するかどうかを判断する.
- 機械的な予備条件の効果と自発的な血栓性エピソード (循環的流れ変数 - CFV) を比較する.
主な方法:
- 犬のモデルは,60分または90分間の持続性イシュケミアを受け,その後に再注射を行った.
- 治療群には,対照群,メカニカル・プリコンディショニング,冠動脈狭窄および内皮損傷によって誘発されたCFVが含まれていました.
- 心臓梗塞のサイズと心筋収縮機能を評価した.
主要な成果:
- メカニカル・プリコンディショニングとCFVの両方が,60分間のイシュケミアの後に心臓発作のサイズを著しく減少させた.
- 結血90分後,CFVのみが対照群と比較して心臓発作のサイズを著しく減少させた.
- どちらの予備条件付け方法も,イシュケミア/再輸液中の,またはその後の収縮機能を保たなかった.
結論:
- 繰り返された冠動脈血栓形成 (CFV) は,高血圧性心筋膜を効果的に前提条件とし,機械的な前提条件よりも長く持続する保護を提供します.
- 機械的または血栓性予備条件付けは,持続したイシュケミアの間に収縮機能を保たず,再注射後の麻痺を予防しません.
- 不安定性アンギナの臨床的なエピソードは,潜在的に急性心筋梗塞の結果に影響を与える,心筋膜を前提にすることができます.
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