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清醒犬短暂反复冠状动脉闭塞诱导的局部心肌容积改变

Regional myocardial volume alterations induced by brief repeated coronary occlusion in conscious dogs.

作者信息

Fujita M, Mikuniya A, McKown D P, McKown M D, Franklin D

机构信息

Dalton Research Center, University of Missouri-Columbia.

出版信息

J Am Coll Cardiol. 1988 Oct;12(4):1048-53. doi: 10.1016/0735-1097(88)90475-5.

Abstract

The purpose of this study was to evaluate whether brief repeated coronary occlusions induce changes in regional myocardial geometry at rest. Five conscious dogs were instrumented for the measurement of subendocardial segment length and transmural wall thickness in the ischemic area, subendocardial segment length in the normally perfused area, coronary flow and left ventricular pressure. After recovery from surgery, 180 (mean) 2 min coronary occlusions were given over a period of 20 days. The heart rate at rest, left ventricular peak systolic and end-diastolic pressures and peak positive first derivative of left ventricular pressure (dP/dt) remained unchanged throughout the experiment. In the normal area, the end-diastolic segment length at rest did not change significantly. By contrast, in the ischemic area, at 14 days after the initiation of repeated coronary occlusion, the end-diastolic regional cross-sectional area (product of segment length and wall thickness) at rest had increased by 9.7% (p less than 0.05); thereafter it decreased to 6.5% (p less than 0.05) above the value at rest before repeated occlusion despite an additional 6 days of coronary occlusions. At 10 days after the interruption of repeated occlusion, this value had regressed to 4.3% (p = NS) above control. These findings suggest the occurrence of regional myocardial hypertrophy confined to the ischemic area in response to the periodic ischemic stimulus.

摘要

本研究的目的是评估短暂反复冠状动脉闭塞是否会在静息状态下引起局部心肌几何形状的改变。对5只清醒犬进行仪器植入,以测量缺血区域的心内膜下节段长度和透壁壁厚、正常灌注区域的心内膜下节段长度、冠状动脉血流和左心室压力。术后恢复后,在20天内进行了180次(平均每次2分钟)冠状动脉闭塞。整个实验过程中,静息心率、左心室收缩压峰值和舒张压末期压力以及左心室压力的峰值正向一阶导数(dP/dt)均保持不变。在正常区域,静息时的舒张末期节段长度无显著变化。相比之下,在缺血区域,反复冠状动脉闭塞开始后14天,静息时的舒张末期局部横截面积(节段长度与壁厚的乘积)增加了9.7%(p<0.05);此后,尽管又进行了6天的冠状动脉闭塞,但该值降至反复闭塞前静息值以上6.5%(p<0.05)。在反复闭塞中断后10天,该值已回归至比对照高4.3%(p=无显著性差异)。这些发现表明,在周期性缺血刺激下,缺血区域会发生局限性心肌肥厚。

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