Department of Cardiology, Saitama Municipal Hospital, Saitama, Japan.
Department of Cardiology, Saitama Municipal Hospital, Saitama, Japan.
Int J Cardiol. 2019 Jan 15;275:36-38. doi: 10.1016/j.ijcard.2018.10.009. Epub 2018 Oct 6.
We recently reported a new approach for cardioprotection, postconditioning with lactate-enriched blood (PCLeB), and a patient with ST-segment elevation myocardial infarction (STEMI), in whom muscle squeezing of the culprit coronary artery was observed immediately after reperfusion with PCLeB. In this study, we examined the prevalence of muscle squeezing immediately after reperfusion in patients with anterior STEMI treated using PCLeB.
PCLeB is a modified postconditioning protocol that comprises intermittent reperfusion and timely coronary injections of lactated Ringer's solution. We treated 30 consecutive patients with anterior STEMI using PCLeB. Among the 30 patients, 4 patients exhibited muscle squeezing of the left anterior descending artery (LAD) immediately after reperfusion. We performed follow-up coronary angiography in 23 patients and found another patient who exhibited muscle squeezing of the LAD. Thus, of 30 patients, 5 were confirmed to have myocardial bridging and 4 exhibited muscle squeezing immediately after reperfusion with PCLeB. No patient died or experienced re-hospitalization for heart failure or recurrent ischemic events at 6 months except for one patient with malignancy.
Muscle squeezing immediately after reperfusion therapy is not a rare phenomenon in patients with anterior STEMI treated using PCLeB.
我们最近报道了一种新的心肌保护方法,即富含乳酸的血液后处理(PCLeB),并在一名接受 PCLeB 再灌注的 ST 段抬高型心肌梗死(STEMI)患者中观察到罪犯冠状动脉的肌肉挤压。在这项研究中,我们检查了接受 PCLeB 治疗的前壁 STEMI 患者再灌注后即刻发生肌肉挤压的发生率。
PCLeB 是一种改良的后处理方案,包括间歇性再灌注和及时向冠状动脉内注射乳酸林格氏液。我们用 PCLeB 治疗了 30 例连续的前壁 STEMI 患者。在这 30 例患者中,4 例患者在再灌注后即刻出现左前降支(LAD)的肌肉挤压。我们对 23 例患者进行了随访冠状动脉造影,发现另一位患者的 LAD 也出现了肌肉挤压。因此,在 30 例患者中,5 例被证实存在心肌桥,4 例在接受 PCLeB 再灌注后即刻出现肌肉挤压。除了 1 例恶性肿瘤患者外,6 个月时无患者死亡或因心力衰竭或再次缺血事件而再住院。
在前壁 STEMI 患者中,接受 PCLeB 治疗后再灌注治疗即刻发生肌肉挤压并非罕见现象。