在慢性缺血性甲膜吐症中,甲膜-心室复合体的几何扭曲
Frederick A Tibayan1, Filiberto Rodriguez, Mary K Zasio
1Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305-5247, USA.
Circulation
|September 13, 2003
概括
慢性缺血性心肌反 (CIMR) 涉及下心肌梗塞后心脏的特定几何变化. 这些包括环状扩张和后面的乳头肌肉位移,对于理解CIMR至关重要.
科学领域:
- 心血管研究研究心血管研究
- 心脏机械学 心脏机械学
- 手术解剖学手术解剖学
背景情况:
- 了解 mitra valvular-ventricular complex 中的三维几何变化对于改善慢性缺血性 mitra regurgitation (CIMR) 的外科修复技术至关重要.
- 下心肌梗塞后的几何变化可能会在心脏中发生CIMR和不发生CIMR之间有所不同.
研究的目的:
- 为了研究下心肌梗塞后慢性缺血性心肌反 (CIMR) 中心膜-心室综合体精确的3维几何变化.
- 为了比较那些开发了CIMR的动物与没有开发的动物的几何变化.
主要方法:
- 24只羊接受了冠状动脉陷安置和标记器植入,围绕着 mitra annulus,乳头肌肉和叶片.
- 低心肌梗塞是由堵塞的边缘分支引起的,影响后面的乳头肌肉.
- 使用 cinefluoroscopy 追踪了三维标记物位置,并在 7 周后根据头回的严重程度分组动物.
主要成果:
- 患有CIMR的动物表现出较大的后侧乳头肌肉从中侧环 (P=0.02) 和更多的横向运动 (P=0.01) 的移动.
- 在CIMR(+) 动物 (P=0.02) 中观察到额头环状隔膜侧面直径的显著增加.
- 在CIMR(+) 组 (P=0.01) 中,也注意到后侧叶片边缘的较大顶部位移 (P=0.01).
结论:
- 较大的隔膜侧环状扩张,侧侧后侧 papillary 肌肉位移,以及顶端后侧叶片限制与CIMR有关.
- 这些几何变化在CIMR.病变发生过程中起着重要作用.
- 对CIMR的治疗策略应该针对环状扩张和后侧乳头肌肉位移.
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