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急性冠状动脉闭塞后等容节段缩短的变化:前壁缺血与后壁缺血的不同影响。

Changes in isovolumic segment shortening following acute coronary occlusion: disproportionate effects of anterior versus posterior ischemia.

作者信息

Fujita M, Sasayama S, Araie E, Yamanishi K, Ohno A, McKown D P, Franklin D

机构信息

Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.

出版信息

Int J Cardiol. 1989 Jan;22(1):29-35. doi: 10.1016/0167-5273(89)90132-0.

Abstract

We evaluated the changes in left ventricular pressure and isovolumic segment shortening in both the ischemic and nonischemic areas following acute coronary occlusion in 12 conscious dogs instrumented for the measurement of subendocardial segment lengths perfused by the left circumflex coronary artery and left anterior descending coronary artery, and left ventricular pressure. An externally inflatable pneumatic occluder was placed around the left circumflex coronary artery. In 6 dogs, another occluder was installed around the proximal left anterior descending coronary artery. Under the resting conditions, the isovolumic segment shortening in the areas supplied by the left anterior descending coronary artery and the left circumflex coronary artery were 2.1 +/- 0.5% (SE) and -0.1 +/- 0.5% (P less than 0.01; versus values in the area of the left anterior descending coronary artery), respectively. During a 1-min occlusion of the left circumflex coronary artery, the isovolumic shortening in the anterior segment increased to 3.8 +/- 0.5% (P less than 0.001; versus values in the basal state), while the posterior segment produced isovolumic elongation (-2.2 +/- 0.5%, P less than 0.001; versus values in the basal state). By contrast, during a 1-min occlusion of the left anterior descending coronary artery, the extent of isovolumic bulge in the anterior segment and the augmentation in the isovolumic shortening in the posterior segment was less prominent compared with the occlusion of the left circumflex coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们评估了12只清醒犬急性冠状动脉闭塞后,左旋支冠状动脉和左前降支冠状动脉灌注的内膜下节段长度以及左心室压力测量装置所测缺血区和非缺血区左心室压力和等容节段缩短的变化。在左旋支冠状动脉周围放置一个外部可充气的气动闭塞器。6只犬在左前降支冠状动脉近端再安装一个闭塞器。静息状态下,左前降支冠状动脉供血区和左旋支冠状动脉供血区的等容节段缩短分别为2.1±0.5%(标准误)和-0.1±0.5%(P<0.01;与左前降支冠状动脉供血区的值相比)。在左旋支冠状动脉闭塞1分钟期间,前节段的等容缩短增加至3.8±0.5%(P<0.001;与基础状态下的值相比),而后节段出现等容延长(-2.2±0.5%,P<0.001;与基础状态下的值相比)。相比之下,在左前降支冠状动脉闭塞1分钟期间,与左旋支冠状动脉闭塞相比,前节段的等容膨出程度和后节段等容缩短的增加不太明显。(摘要截短至250字)

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