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缺血持续时间对侧支循环发育至关重要:清醒犬反复短暂冠状动脉闭塞

Duration of ischemia is vital for collateral development: repeated brief coronary artery occlusions in conscious dogs.

作者信息

Mohri M, Tomoike H, Noma M, Inoue T, Hisano K, Nakamura M

机构信息

Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Circ Res. 1989 Feb;64(2):287-96. doi: 10.1161/01.res.64.2.287.

Abstract

The effects of two types of repeated transient coronary artery occlusions on collateral development were examined in chronically instrumented, conscious dogs. A 2-minute coronary occlusion at 32-minute intervals (group 1, n = 11) or a 15-second occlusion at 4-minute intervals (group 2, n = 7) were repeated day and night without interruption. In both groups, the total duration of coronary occlusions each day was the same (90 minutes). Before and after repetitive occlusions of either group, effects of transient 2-minute coronary occlusion on regional segment shortening in the ischemic area were examined to assess the functional state of the collateral vessels. In group 1, systolic segment shortening in the area rendered ischemic was reduced to -97.8 +/- 17.7% of the preocclusive control value during 2 minutes of coronary occlusion. After 125-478 repetitive occlusions (3-11 days), the degree of hypokinesia during the 2-minute occlusion was significantly improved to -0.6 +/- 4.6% of the preocclusive value (p less than 0.001 vs. before the repetition). In group 2, it remained unchanged even after 3,500-5,450 repetitive occlusions (11-16 days): -111.8 +/- 8.2% before and -111.4 +/- 13.8% after the repetition of 15-second occlusions (NS). The ratio of peripheral coronary arterial pressure to aortic pressure during transient-coronary occlusion, measured by selective catheterization, was significantly higher in group 1 than in group 2 (64.4 +/- 5.3% vs. 20.7 +/- 1.3%, p less than 0.001). These findings suggest that myocardial ischemia of 2 minutes but not 15 seconds is vital to provide effective stimuli for angiogenesis.

摘要

在长期植入仪器的清醒犬中,研究了两种类型的反复短暂冠状动脉闭塞对侧支循环发育的影响。以32分钟的间隔进行2分钟的冠状动脉闭塞(第1组,n = 11)或以4分钟的间隔进行15秒的闭塞(第2组,n = 7),日夜不停重复进行。两组中,每天冠状动脉闭塞的总时长相同(90分钟)。在任一组进行重复性闭塞前后,检测短暂2分钟冠状动脉闭塞对缺血区域节段缩短的影响,以评估侧支血管的功能状态。在第1组中,冠状动脉闭塞2分钟期间,缺血区域的收缩期节段缩短减少至闭塞前对照值的-97.8±17.7%。在125 - 478次重复性闭塞(3 - 11天)后,2分钟闭塞期间的运动减退程度显著改善至闭塞前值的-0.6±4.6%(与重复前相比,p < 0.001)。在第2组中,即使在3500 - 5450次重复性闭塞(11 - 16天)后仍无变化:15秒闭塞重复前为-111.8±8.2%,重复后为-111.4±13.8%(无显著性差异)。通过选择性导管插入术测量的短暂冠状动脉闭塞期间外周冠状动脉压力与主动脉压力之比,第1组显著高于第2组(64.4±5.3%对20.7±1.3%,p < 0.001)。这些发现表明,2分钟而非15秒的心肌缺血对于提供有效的血管生成刺激至关重要。

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