Figulla H R, Vetterlein F, Glaubitz M, Kreuzer H
Circulation. 1987 Jul;76(1):208-16. doi: 10.1161/01.cir.76.1.208.
There is clinical evidence that human dilated cardiomyopathy is related to microcirculatory disorders. We used an experimental preparation of the disease that consisted of a study of the microcirculation of 45 cardiomyopathic Syrian and 18 control hamsters with timed plasma staining. To investigate dynamic vascular disorders a double injection technique was used that permitted demonstration of all permanently and temporarily perfused capillaries in the same animal. The results showed a total capillary density of 3423 +/- 470 capillaries/mm2 in the cardiomyopathic hamster during the premyocytolic phase (30 days of age) and that of 3289 +/- 506 capillaries/mm2 during the myocytolytic phase (44 days). These values were not significantly different from those in the control group (3349 +/- 473 capillaries/mm2 at 30 days and 3383 +/- 556 capillaries/mm2 at 44 days). However, tissue areas with extended coronary transit times were detected only in the cardiomyopathic hamsters. These areas were of the same individual and cumulative size at 30 days (diameter approximately 200 micron, 4% of the tissue) as the myocytolytic zones at 44 days. In cardiomyopathic hamsters verapamil and hydralazine prevented both hypoperfusion and myocytolysis. The results favor the view that microcirculatory disorders generate tissue damage in the cardiomyopathic hamster and that these disorders can be prevented through treatment with the calcium antagonist verapamil or with the vasodilator hydralazine.
有临床证据表明,人类扩张型心肌病与微循环障碍有关。我们采用了一种该疾病的实验制剂,包括对45只患心肌病的叙利亚仓鼠和18只对照仓鼠的微循环进行定时血浆染色研究。为了研究动态血管障碍,采用了双注射技术,该技术能够在同一只动物中显示所有永久性和临时性灌注的毛细血管。结果显示,在心肌病仓鼠的前肌细胞期(30日龄),毛细血管总密度为3423±470根毛细血管/mm²,在肌细胞溶解期(44日龄)为3289±506根毛细血管/mm²。这些数值与对照组(30日龄时为3349±473根毛细血管/mm²,44日龄时为3383±556根毛细血管/mm²)无显著差异。然而,仅在患心肌病的仓鼠中检测到冠状动脉 transit 时间延长的组织区域。这些区域在30日龄时的个体大小和累积大小(直径约200微米,占组织的4%)与44日龄时的肌细胞溶解区相同。在患心肌病的仓鼠中,维拉帕米和肼屈嗪可预防灌注不足和肌细胞溶解。这些结果支持以下观点:微循环障碍在患心肌病的仓鼠中导致组织损伤,并且这些障碍可以通过用钙拮抗剂维拉帕米或血管扩张剂肼屈嗪进行治疗来预防。