冠状动脉循环流量变化"先决条件"缺血性心肌
M Ovize1, R A Kloner, S L Hale
1Heart Institute Hospital of the Good Samaritan, Los Angeles, CA 90017.
Circulation
|February 1, 1992
概括
自发的冠状动脉血栓形成可以预先调节心脏,减少心脏病发作的大小,类似于机械预先调节. 循环流变化 (CFV) 的这种保护作用即使在较长时间的缺血后也会持续下去,与机械预调节不同.
科学领域:
- 心血管科学 心血管科学
- 缺血性心脏病研究 缺血性心脏病研究
- 肌心脏保护机制 肌心脏保护机制
背景情况:
- 通过短暂的冠状动脉封闭进行机械预调,可以减少心脏病发作的大小.
- 自发性暂时性缺血的心脏保护作用,就像不稳定性心痛一样,是未知的.
研究的目的:
- 为了确定自发性血栓发作是否限制心脏病发作的大小,并在持续性缺血和再输后保持收缩功能.
- 为了比较机械预制与自发血栓发作 (循环流变化 - CFV) 的影响.
主要方法:
- 狗模型经历了60或90分钟的持续性缺血,然后再输血.
- 治疗组包括对照组,机械预调和冠状动脉狭窄和内皮损伤引起的CFV.
- 评估了心脏梗塞的大小和心肌收缩功能.
主要成果:
- 机械预调和CFV都显著减少了60分钟的缺血后的心脏病发作的大小.
- 经过90分钟的缺血,与对照组相比,只有CFV显著减少了心脏病发作的大小.
- 两种预先调节方法都没有在缺血/再输液期间或之后保留收缩功能.
结论:
- 重复冠状动脉血栓形成 (CFV) 有效地预先条件缺血性心肌,提供比机械预先条件更长时间的保护.
- 无论是机械的还是血栓的预调,都不能在持续性缺血期间保持收缩功能,也不能防止再输血后的麻醉.
- 不稳定性心痛的临床发作可能会预先条件心肌,可能会影响急性心肌梗塞的结果.
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