Isoyama S, Ito N, Kuroha M, Takishima T
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
J Clin Invest. 1989 Jul;84(1):288-94. doi: 10.1172/JCI114153.
Using an experimental model of ascending aortic banding in the rat, we examined whether coronary circulation abnormalities in hypertrophied hearts are reversible after debanding. 4-wk banding produced significant increases in in vivo left ventricular (LV) pressure (194 +/- 13 vs. 114 +/- 9 mmHg in shamoperated controls) and LV dry wt/body wt (48 +/- 5% above controls). In isolated hearts perfused with Krebs-Henseleit buffer, coronary flow rate (CFR) was estimated under nonworking conditions. During maximal vasodilation after 1 min-ischemia, CFR at a coronary perfusion pressure (CPP) of 100 mmHg and CFR/myocardidial mass at CPPs of 100 and 150 mmHg decreased significantly (72 +/- 5%; 53 +/- 4 and 61 +/- 4% of controls). 1 or 4 wk after debanding, LV systolic pressures were similar to control values, and the degree of myocardial hypertrophy decreased to levels 23 +/- 6 (P less than 0.01) and 11 +/- 6% (P less than 0.01) above their control values, respectively. At 1 wk there was no significant increase in CFR/myocardial mass, compared to values in the banded group (67 +/- 8 vs. 53 +/- 4% of controls at 100 mmHg and 67 +/- 9 vs. 61 +/- 4% at 150 mmHg of CPP). At 4 wk, CFR and the ratio had increased toward normal. Thus, decreased coronary perfusion in hypertrophied hearts is completely reversible.
利用大鼠升主动脉缩窄实验模型,我们研究了肥厚型心脏的冠状动脉循环异常在解除缩窄后是否可逆。4周的缩窄导致体内左心室(LV)压力显著升高(假手术对照组为114±9 mmHg,缩窄组为194±13 mmHg),左心室干重/体重也显著增加(比对照组高48±5%)。在用Krebs-Henseleit缓冲液灌注的离体心脏中,在非工作状态下估计冠状动脉血流速度(CFR)。在1分钟缺血后的最大血管舒张期,冠状动脉灌注压(CPP)为100 mmHg时的CFR以及CPP为100和150 mmHg时的CFR/心肌质量均显著降低(分别为对照组的72±5%;53±4%和61±4%)。解除缩窄1周或4周后,左心室收缩压与对照值相似,心肌肥厚程度分别降至比对照值高23±6%(P<0.01)和11±6%(P<0.01)的水平。与缩窄组相比,1周时CFR/心肌质量无显著增加(100 mmHg时为对照组的67±8% vs. 53±4%,150 mmHg CPP时为67±9% vs. 61±4%)。4周时,CFR及其比值已向正常水平增加。因此,肥厚型心脏中冠状动脉灌注减少是完全可逆的。