Yoshida H, Matsubara K, Haraoka S, Yamanari H, Ihara K, Hagiwara H, Kobiki N, Togawa J, Shiraki T, Lux R L
Central Laboratory of Okayama University Medical School.
Kokyu To Junkan. 1990 Apr;38(4):367-74.
For studying the effect of regional myocardial blood flow changes on the epicardial ECG of right and left ventricular walls under acute right ventricular pressure overload, we mapped the epicardial using 64-channel shock electrodes, and estimated the myocardial blood flow with radioactive microspheres. In 9 anesthetized open-chest dogs, the main pulmonary artery was gradedly constricted to the level of mild (peak RV pressure: PRVP, 50-70 mmHg), moderate (PRVP, 70-80 mmHg) and severe stenosis (PRVP, over 80 mmHg). Labeled microspheres were injected into the left atrium before and after the PA constriction, and the epicardial ECGs were recorded continuously. After the completion of the experiment, 9 areas of each right and left ventricular wall were excised. The myocardium was divided into three layers and the flow data were compared to the changes of ECG parameters. In the cases where there was severe PA stenosis, the right ventricular myocardial blood flow decreased to a significantly greater degree (63% reduction from the control), especially in the subepicardial layer, than the flow in the left ventricle (37% reduction from the control). ST potential, STT and QRST Area Map increased in the right ventricle but decreased in the left ventricle. Activation Recovery Time of the right ventricle decreased due to the severe ischemia of the right ventricle. The value of QRS Area Map of the left ventricle decreased significantly in parallel with the decrease in cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)
为研究急性右心室压力超负荷情况下,局部心肌血流变化对左右心室壁心外膜心电图的影响,我们使用64通道电击电极绘制心外膜图,并通过放射性微球估计心肌血流。在9只麻醉开胸犬中,逐步将主肺动脉缩窄至轻度(右心室峰值压力:PRVP,50 - 70 mmHg)、中度(PRVP,70 - 80 mmHg)和重度狭窄(PRVP,超过80 mmHg)水平。在肺动脉缩窄前后将标记微球注入左心房,并连续记录心外膜心电图。实验结束后,切除左右心室壁的9个区域。将心肌分为三层,并将血流数据与心电图参数变化进行比较。在肺动脉重度狭窄的情况下,右心室心肌血流下降幅度显著更大(比对照组减少63%),尤其是在心外膜下层,而左心室血流下降幅度为(比对照组减少37%)。右心室的ST电位、STT和QRST面积图增加,而左心室则下降。由于右心室严重缺血,右心室的激活恢复时间缩短。左心室的QRS面积图值与心输出量下降同步显著降低。(摘要截断于250字)