节奏诱导和流量限制性缺血对左心室功能的影响比较
R J Applegate1, R A Walsh, R A O'Rourke
1Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Circulation
|April 1, 1990
概括
这项研究比较了来自快速心房节奏的需求缺血与来自狗冠状动脉封闭的供应缺血. 冠状动脉封闭导致血液流量更严重减少,左心室功能更严重受损,而不是节奏诱导的缺血症.
科学领域:
- 心血管生理学心血管生理学
- 心肌缺血的研究研究心肌缺血.
- 心脏病学中的动物模型
背景情况:
- 了解需求与供应缺血对左心室 (LV) 功能的明显影响,对于治疗缺血性心脏病至关重要.
- 之前的研究没有直接比较在同一动物模型中这两种类型的缺血的功能后果.
研究的目的:
- 为了比较需求缺血症 (由快速心房节奏引起) 和供应缺血症 (由双侧冠状动脉封闭引起) 对LV心肌血流和功能的影响.
- 为了阐明这两个缺血状态之间的腹腔功能障碍的潜在定性差异.
主要方法:
- 利用14只接受巴比特麻醉的狗来诱导和比较两种类型的缺血症:通过快速心房节奏要求缺血症和通过完全双侧冠状动脉封闭提供缺血症.
- 测量了区域上心脏和内心脏血流量,并使用血液动力学参数,如dP/dtmax,LV终端-透气维度 (EDD) 和LV终端-透气压力 (EDP) 来评估LV系统和透气功能.
主要成果:
- 节奏诱导性缺血和双侧冠状动脉封闭 (BCO) 都显著减少了心肌血流,而BCO导致更严重的减少.
- 节奏诱导的缺血导致心缩损伤,心室扩张和腹功能障碍,包括放松功能受损和腔室刚度增加.
- 双边冠状动脉封闭导致较早和更明显的 LV 功能障碍,其特点是较高的 LV 末端透缩压,较大的腹腔扩张和相比节奏诱导性缺血症的缩小尺寸.
结论:
- 由快速心房节奏诱导的需求缺血,导致左心室的收缩性衰竭和被动性扩张性功能障碍.
- 由双侧冠状动脉封闭引起的供应缺血导致左心室功能和血液动力学变化比需求缺血更严重和更快.
- 这种动物模型有效地区分了需求与供应缺血对心肌的功能影响.
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