Salmons S, Jarvis J C
Department of Human Anatomy and Cell Biology, University of Liverpool.
Br Heart J. 1992 Sep;68(3):333-8. doi: 10.1136/hrt.68.9.333.
We review here various ways in which cardiac assistance might be derived from a patient's own skeletal muscle. Calculations based on experimental data and optimistic estimates of the efficiency of the energy conversions involved suggest that the continuous assist available would be limited to about 2 litres a minute if a muscle were used to energise an electromechanical device. It would be more efficient to couple the energy mechanically or hydraulically, but these approaches still pose problems of anatomical placement, muscle attachment, fluid leakage, and cost. Unless these issues can be addressed, the use of skeletal muscle as an internal power source for mechanical circulatory assist devices will remain an unworkable concept. Configurations that couple skeletal muscle contraction directly to the circulation would be more efficient and less costly. In terms of the energy available, a skeletal muscle ventricle could be designed to provide a continuous partial assist of 1-2 l/min, with flows of up to 8 l/min sustainable for limited periods. Such an approach offers new possibilities for the surgical treatment of chronic cardiac failure.
在此，我们回顾了从患者自身骨骼肌获取心脏辅助的各种方式。基于实验数据以及对相关能量转换效率的乐观估计进行的计算表明，如果使用肌肉为机电装置提供能量，持续可用的辅助量将限制在每分钟约2升。以机械或液压方式耦合能量会更高效，但这些方法仍存在解剖位置、肌肉附着、液体泄漏和成本等问题。除非这些问题能够得到解决，否则将骨骼肌用作机械循环辅助装置的内部动力源仍将是一个不可行的概念。将骨骼肌收缩直接与循环系统耦合的配置会更高效且成本更低。就可用能量而言，骨骼肌心室可设计为提供每分钟1 - 2升的持续部分辅助，在有限时间段内可持续提供高达每分钟8升的流量。这种方法为慢性心力衰竭的外科治疗提供了新的可能性。
