Canbaz S, Kolbakir F, Keçelıgıl H T, Demır Z, Erk M K
Department of Thoracic and Cardiovascular Surgery, Medical Faculty, Ondokuzmayis University, Samsun, Turkey.
Exp Clin Cardiol. 2001 Summer;6(2):99-104.
To evaluate the effect of coronary sinus diastolic balloon pulsation (CSDBP) on acute myocardial ischemia and infarction. It was hypothesized that this procedure would improve retrograde flow to ischemic areas and allow for more complete oxygen exchange and venous washout of metabolites, with elevated coronary sinus pressure and retrograde pulsation.
This two-part study was done on 10 dogs. First, CSDBP was applied to normal myocardium by a balloon catheter and a pump system at beat to beat cardiac cycles of 1:1, 2:1 and 3:1. Then coronary ischemia was obtained by coronary artery ligation and the procedure was repeated. Electrocardiographic (ECG), arterial and coronary sinus pressure alterations were monitored continuously, and arterial, mixed venous and coronary sinus blood lactate concentrations were measured at each stage of the study.
In the first stage no hemodynamic deterioration was observed. In the second stage, mean ECG-ST segment elevation was 6.30+/-0.95 mm (P<0.01) and coronary sinus blood lactate concentration increased to 5.37+/-0.37 mmol/L from 1.95+/-0.31 mmol/L (P<0.01). ECG-ST segment elevation decreased to 3.73+/-0.64 mm and coronary sinus blood lactate concentration decreased to 4.79+/-0.28 mmol/L (P<0.05) with 1:1 beat to beat CSDBP. ECG-ST segment elevation decreased to 2.95+/-0.73 mm and coronary sinus blood lactate concentration decreased to 4.4+/-0.22 mmol/L with 2:1 CSDBP. ECG-ST segment elevation decreased to 3.6+/-0.42 mm and coronary sinus blood lactate concentration decreased to 4.17+/-0.22 mmol/L with 3:1 CSDBP as well.
Results showed that CSDBP technique lowered the increased ECG-ST segment elevation and myocardial lactate production.
评估冠状静脉窦舒张期球囊搏动（CSDBP）对急性心肌缺血和梗死的影响。研究假设该操作可改善缺血区域的逆向血流，实现更完全的氧交换以及代谢产物的静脉清除，同时伴有冠状静脉窦压力升高和逆向搏动。
这项分为两部分的研究在10只犬身上进行。首先，通过球囊导管和泵系统，在1:1、2:1和3:1的逐搏心动周期下，将CSDBP应用于正常心肌。然后通过冠状动脉结扎造成冠状动脉缺血，并重复该操作。持续监测心电图（ECG）、动脉和冠状静脉窦压力变化，在研究的每个阶段测量动脉、混合静脉和冠状静脉窦血乳酸浓度。
在第一阶段未观察到血流动力学恶化。在第二阶段，平均心电图ST段抬高为6.30±0.95毫米（P<0.01），冠状静脉窦血乳酸浓度从1.95±0.31毫摩尔/升增至5.37±0.37毫摩尔/升（P<0.01）。采用1:1逐搏CSDBP时，心电图ST段抬高降至3.73±0.64毫米，冠状静脉窦血乳酸浓度降至4.79±0.28毫摩尔/升（P<0.05）。采用2:1 CSDBP时，心电图ST段抬高降至2.95±0.73毫米，冠状静脉窦血乳酸浓度降至4.4±0.22毫摩尔/升。采用3:1 CSDBP时，心电图ST段抬高降至3.6±0.42毫米，冠状静脉窦血乳酸浓度降至4.17±0.22毫摩尔/升。
结果表明，CSDBP技术降低了升高的心电图ST段抬高和心肌乳酸生成。
