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犬冠状动脉的压力-流量特性及营养能力

Pressure-flow characteristics and nutritional capacity of coronary veins in dogs.

作者信息

Cohen M V, Matsuki T, Downey J M

机构信息

Department of Physiology, University of South Alabama College of Medicine, Mobile 36688.

出版信息

Am J Physiol. 1988 Oct;255(4 Pt 2):H834-46. doi: 10.1152/ajpheart.1988.255.4.H834.

Abstract

To examine the hemodynamic interdependence of coronary arteries and veins, great cardiac vein (GCV) and left anterior descending (LAD) coronary artery flows of dogs were measured. Although they were not different under base-line conditions, 42.9 +/- 4.1 and 34.9 +/- 5.2 ml/min, respectively, LAD occlusion caused only a 56% decrease in GCV flow, whereas peak GCV flow during reactive hyperemia consistently underestimated peak LAD flow by nearly 40%. The measured hemodynamic data were very closely predicted by a simple model that assumed the presence of a low-resistance venous collateral anastomotic pathway between the GCV and veins outside the LAD territory. The resistance of the venous collaterals averaged 9.9 +/- 3.0% of LAD resistance. Therefore, GCV flow does not solely represent LAD collateral flow when the LAD is occluded, nor is it a reliable indicator of changes in LAD perfusion patterns. Nutritional myocardial perfusion assessed with 133Xe washout decreased from 0.86 +/- 0.16 to 0.13 +/- 0.02 ml.min-1.g-1 after LAD occlusion, whereas retroperfusion of the GCV with arterial blood enhanced washout by 85% to 0.23 +/- 0.03 ml.min-1.g-1 (P less than 0.005). Retroperfusion was inefficient, however, since only 10% of the isotope injected into the GCV gained access to the myocardium.

摘要

为研究冠状动脉与静脉之间的血流动力学相互依存关系,对犬的大冠状静脉(GCV)和左前降支(LAD)冠状动脉血流进行了测量。尽管在基线条件下两者并无差异,分别为42.9±4.1和34.9±5.2 ml/min,但LAD闭塞仅导致GCV血流减少56%,而反应性充血期间的GCV峰值血流始终比LAD峰值血流低估近40%。通过一个简单模型能很好地预测所测得的血流动力学数据,该模型假定在GCV与LAD区域外的静脉之间存在低阻力静脉侧支吻合通路。静脉侧支的阻力平均为LAD阻力的9.9±3.0%。因此,当LAD闭塞时,GCV血流并不完全代表LAD的侧支血流,也不是LAD灌注模式变化的可靠指标。用133Xe洗脱法评估的心肌营养性灌注在LAD闭塞后从0.86±0.16降至0.13±0.02 ml·min-1·g-1,而用动脉血对GCV进行逆向灌注可使洗脱增强85%,达到0.23±0.03 ml·min-1·g-1(P<0.005)。然而,逆向灌注效率不高,因为注入GCV的同位素仅有10%进入心肌。

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