O'Keefe D D, Hoffman J I, Cheitlin R, O'Neill M J, Allard J R, Shapkin E
Circ Res. 1978 Jul;43(1):43-51. doi: 10.1161/01.res.43.1.43.
To determine whether left ventricular hypertrophy [LVH] altered total and regional coronary blood flow, we inflated a balloon around the ascending aorta of nine dogs; six acute and six sham-operated dogs were controls. After 6 weeks, all dogs were studied with an open chest under anesthesia; the balloons were deflated. There was moderate LVH as shown by increased left ventricular weight and fiber diameter. At rest there were no major differences of coronary flow or resistance per gram of muscle. With maximal coronary vasodilation due to adenosine or carbochrome, mean coronary vascular resistance was 84% higher in LVH than in normal hearts; with isoproterenol, resistance was 54% higher in LVH. These changes were similar in right and left ventricles. Minimal coronary resistance at end diastole also was higher in LVH--64% and 94% for the two sets of vasodilators, respectively. There were no significant differences in capillary or large vessel proportional volumes in LVH and control dogs, but arterial capacity could not be estimated. The raised minimal coronary resistance suggests the possibility that, with stress, coronary flow, especially to subendocardial muscle, might be inappropriate and perhaps cause ischemic damage. However, the changes noted might have been due to coronary arterial responses to raised coronary pressures rather than to hypertrophy itself.
为了确定左心室肥厚(LVH)是否改变冠状动脉总血流量和局部血流量,我们在9只狗的升主动脉周围放置一个气囊;6只急性手术狗和6只假手术狗作为对照。6周后,所有的狗在麻醉下开胸进行研究;气囊放气。左心室重量和纤维直径增加表明存在中度LVH。静息时,每克心肌的冠状动脉血流量或阻力无显著差异。在腺苷或卡巴克络引起最大程度的冠状动脉血管舒张时,LVH组的平均冠状动脉血管阻力比正常心脏高84%;在异丙肾上腺素作用下,LVH组的阻力高54%。左右心室的这些变化相似。LVH组舒张末期最小冠状动脉阻力也较高,两组血管扩张剂分别为64%和94%。LVH组和对照组狗的毛细血管或大血管比例容积无显著差异,但无法估计动脉容量。升高的最小冠状动脉阻力提示,在应激状态下,冠状动脉血流量,尤其是心内膜下心肌的血流量,可能不适当,甚至可能导致缺血性损伤。然而,观察到的这些变化可能是由于冠状动脉对升高的冠状动脉压力的反应,而非肥厚本身所致。