Mohri M, Tomoike H, Inoue T, Nakamura M
Research Institute of Angiocardiology and Cardiovascular Clinic, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am Heart J. 1989 Jan;117(1):43-52. doi: 10.1016/0002-8703(89)90655-8.
Effects of beta-adrenergic blockade on regional myocardial dysfunction induced by coronary artery occlusion were studied in chronically instrumented, conscious dogs before (n = 8) and after (n = 7) collateral development. Intravenous atenolol or propranolol produced no beneficial effects on systolic shortening in the area rendered ischemic during 2 minutes of circumflex occlusion, before collateral development. After the collateral development by repetitive 2-minute coronary occlusions, regional asynergy recovered to the preocclusive level during 2 minutes of occlusion. Both atenolol and propranolol significantly improved the peak reductions of regional shortening by 19 +/- 9% and 18 +/- 9%, respectively (p less than 0.05 versus without beta-blockade). These beneficial actions of beta-blockade were again noted during atrial tachypacing at matched heart rates of 160 +/- 11 beats/min. Thus the beneficial effects of beta-blockade on regional asynergy during coronary occlusion depend on the level of functional state of the collaterals and cannot be totally accounted for by the reduction in heart rate or by the cardioselectivity.
在慢性植入仪器的清醒犬中,研究了β-肾上腺素能阻滞剂对冠状动脉闭塞所致局部心肌功能障碍的影响,实验分为侧支循环形成前(n = 8)和侧支循环形成后(n = 7)两个阶段。在侧支循环形成前,左旋支闭塞2分钟期间,静脉注射阿替洛尔或普萘洛尔对缺血区域的收缩期缩短无有益作用。通过重复2分钟冠状动脉闭塞形成侧支循环后,闭塞2分钟期间局部协同失调恢复到闭塞前水平。阿替洛尔和普萘洛尔均显著改善局部缩短的峰值降低,分别改善了19±9%和18±9%(与未用β-阻滞剂相比,p<0.05)。在心房快速起搏时,心率匹配为160±11次/分钟,再次观察到β-阻滞剂的这些有益作用。因此,β-阻滞剂对冠状动脉闭塞期间局部协同失调的有益作用取决于侧支循环的功能状态水平,不能完全用心率降低或心脏选择性来解释。