Tsuiki K, Ohta I, Oh-hara N, Kaminishi T, Oguma M, Yasui S
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
J Cardiovasc Pharmacol. 1989 Aug;14(2):268-77. doi: 10.1097/00005344-198908000-00013.
Effect of intracoronary infusion of diltiazem (1 microgram/min) on regional myocardial blood flow (RMBF) was studied using 15-microns radioactive microspheres in 11 excised cross-circulated canine left ventricles. With total coronary blood flow (CBF) and heart rate (HR) held constant, regional ischemia was induced by ligating the left anterior descending coronary artery (LAD). Diltiazem at the dose used had no effects on ventricular Emax before and after LAD ligation. RMBF expressed by the counts divided by the counts averaged in all segments in each layer significantly (p less than 0.05) increased under diltiazem only in the low-flow region that had less than 50% RMBF before diltiazem; from 21% (+/- 12%) to 35% (+/- 18%) in the epicardial, from 22% (+/- 12%) to 32% (+/- 18%) in the midwall, and from 24% (+/- 10%) to 31% (+/- 12%) in the endocardial layers. We conclude that the beneficial effect of diltiazem on the ischemic heart involves a direct action on the coronary vascular system and does not necessarily depend on the concomitant changes in hemodynamics.
使用15微米放射性微球，在11个离体交叉循环犬左心室中研究了冠状动脉内输注地尔硫䓬（1微克/分钟）对局部心肌血流量（RMBF）的影响。在总冠状动脉血流量（CBF）和心率（HR）保持恒定的情况下，通过结扎左冠状动脉前降支（LAD）诱导局部缺血。所用剂量的地尔硫䓬对LAD结扎前后的心室Emax无影响。仅在用药前RMBF低于50%的低血流区域，地尔硫䓬使以计数除以每层所有节段平均计数表示的RMBF显著（p<0.05）增加；心外膜层从21%（±12%）增至35%（±18%），中层从22%（±12%）增至32%（±18%），心内膜层从24%（±10%）增至31%（±12%）。我们得出结论，地尔硫䓬对缺血心脏的有益作用涉及对冠状动脉血管系统的直接作用，不一定依赖于血流动力学的伴随变化。
