Dzwonczyk Roger, del Rio Carlos, McSweeney Thomas D, Zhang Xiaoli, Howie Michael B
Department of Anesthesiology, The Ohio State University, Doan Hall, Columbus, OH 43210-1228, USA.
J Clin Monit Comput. 2009 Aug;23(4):217-22. doi: 10.1007/s10877-009-9185-9. Epub 2009 Jun 20.
Myocardial electrical impedance (MEI) has shown to be an effective indicator of myocardial ischemia. We have previously developed a novel monitor for measuring MEI in near-real time. The object of this study was to test whether drug-induced changes in the frequency of the periodic myocardial electrical activity, as measured by the heart rate (HR), affect MEI measurements made with our monitor.
Thirty dogs were randomly assigned to one of three study groups (placebo, isoproterenol or esmolol) and then anesthetized with sodium thiamylal, intubated, ventilated, given isoflurane, and had venous, arterial, and pulmonary artery catheters placed. Median sternotomy was performed to facilitate myocardial exposure and to allow the left anterior descending (LAD) coronary artery to be isolated. Following baseline measurements, saline (control), isoproterenol or esmolol was administered and the LAD coronary artery was occluded in a timed sequence in order to study the effects of heart rate changes and demonstrate induced myocardial ischemia on MEI.
Isoproterenol raised the HR and esmolol lowered the HR without affecting our MEI measurements. Myocardial electrical impedance increased during LAD coronary artery occlusion in all groups, as previously shown.
These results demonstrate that our MEI monitor is unaffected by the frequency of the periodic myocardial electrical activity that generates the HR.
心肌电阻抗(MEI)已被证明是心肌缺血的有效指标。我们之前开发了一种新型监测仪,用于近实时测量MEI。本研究的目的是测试药物诱导的周期性心肌电活动频率变化(通过心率(HR)测量)是否会影响使用我们的监测仪进行的MEI测量。
30只狗被随机分配到三个研究组之一(安慰剂组、异丙肾上腺素组或艾司洛尔组),然后用硫喷妥钠麻醉,插管,通气,给予异氟烷,并放置静脉、动脉和肺动脉导管。进行正中胸骨切开术以利于心肌暴露,并分离左前降支(LAD)冠状动脉。在进行基线测量后,给予生理盐水(对照)、异丙肾上腺素或艾司洛尔,并按时间顺序阻断LAD冠状动脉,以研究心率变化的影响,并证明诱导的心肌缺血对MEI的影响。
异丙肾上腺素使心率升高,艾司洛尔使心率降低,但均未影响我们的MEI测量。如前所示,在所有组中,LAD冠状动脉闭塞期间心肌电阻抗均增加。
这些结果表明,我们的MEI监测仪不受产生心率的周期性心肌电活动频率的影响。