Stevens L, Badylak S F, Janas W, Gray M, Geddes L A, Voorhees W D
Hillenbrand Biomedical Engineering Center, Purdue University, West Lafayette, Indiana 47907.
J Surg Res. 1989 Jan;46(1):84-9. doi: 10.1016/0022-4804(89)90185-6.
This study examined the ability of a skeletal muscle-powered assist ventricle to augment cardiac output in 10 dogs with experimentally induced heart failure. Heart failure was induced with the use of the beta-blocking agents atenolol and propranolol. A "skeletal muscle ventricle" was then surgically constructed by wrapping the rectus abdominis muscle, with an intact neurovascular supply, around a double open-ended compressible pouch. The skeletal muscle ventricle was then interposed in a left ventricular apicoaortic conduit. The motor nerves to the skeletal muscle ventricle were stimulated by a custom designed pulse generator and caused tetanic contraction of the ventricle during diastole of every fourth natural heart beat. Stimulation was continued for 60 min. Cardiac output, systolic and diastolic blood pressures, mean blood pressure, left ventricular end diastolic pressure, and central venous pressure were then monitored prior to, during, and several times after skeletal muscle ventricle stimulation to evaluate assist ventricle function. There was an increased cardiac output in all 10 dogs at all recording times during skeletal muscle ventricle assistance compared to the cardiac output prior to stimulation of the assist ventricle. The mean increase in cardiac output after 30 min of assist ventricle stimulation was 31.0 +/- 14% (P less than 0.01), and at 60 min was 8.0 +/- 1% (P less than 0.05). The mean diastolic blood pressure after 1 and 30 min of skeletal muscle ventricle assistance (50.0 +/- 2.9 and 48.6 +/- 2.2 mm Hg, respectively) was increased (P less than 0.05) vs the preassistance value (44.9 +/- 2.8 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究检测了骨骼肌动力辅助心室增加10只实验性诱导心力衰竭犬心输出量的能力。使用β受体阻滞剂阿替洛尔和普萘洛尔诱导心力衰竭。然后通过将具有完整神经血管供应的腹直肌围绕一个双开口可压缩袋进行手术构建“骨骼肌心室”。接着将骨骼肌心室置于左心室心尖主动脉管道中。通过定制的脉冲发生器刺激骨骼肌心室的运动神经,使其在每第四个自然心跳的舒张期发生强直性收缩。刺激持续60分钟。然后在骨骼肌心室刺激前、刺激期间以及刺激后多次监测心输出量、收缩压和舒张压、平均血压、左心室舒张末期压力和中心静脉压力,以评估辅助心室功能。与辅助心室刺激前的心输出量相比,在骨骼肌心室辅助期间的所有记录时间点,所有10只犬的心输出量均增加。辅助心室刺激30分钟后心输出量的平均增加为31.0±14%(P<0.01),60分钟时为8.0±1%(P<0.05)。骨骼肌心室辅助1分钟和30分钟后的平均舒张压(分别为50.0±2.9和48.6±2.2 mmHg)较辅助前值(44.9±2.8 mmHg)升高(P<0.05)。(摘要截短为250字)