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选择性心脏去神经支配的清醒犬对冠状动脉闭塞的反应

Responses to coronary artery occlusion in conscious dogs with selective cardiac denervation.

作者信息

Shen Y T, Knight D R, Vatner S F, Randall W C, Thomas J X

机构信息

Department of Medicine, Harvard Medical School, Boston, Massachusetts.

出版信息

Am J Physiol. 1988 Sep;255(3 Pt 2):H525-33. doi: 10.1152/ajpheart.1988.255.3.H525.

Abstract

The extent to which cardiac denervation alters responses to myocardial ischemia remains controversial. This study compared responses to 24-h coronary artery occlusion (CAO) on measurements of wall thickness (ultrasonic crystals), regional myocardial blood flow (microspheres), and infarct size (triphenyltetrazolium chloride technique) in three groups of conscious dogs with 1) selective posterior left ventricular (LV) wall denervation, 2) selective ventricular denervation, or in 3) intact dogs. After CAO, hemodynamic changes were not different among the three groups. Wall thickening in the ischemic zone became akinetic or paradoxical early after CAO and did not recover in any group over the 24-h monitoring period. Blood flow in the area at risk fell similarly in all groups. Infarct size, as a percentage of the area at risk, was 45 +/- 7% in intact, 48 +/- 6% in posterior LV wall-denervated, and 48 +/- 8% in ventricular-denervated group. There was, however, a lower (P less than 0.05) frequency of arrhythmic beats per minute after 3 h of CAO in the ventricular-denervated group (3.2 +/- 1.4) compared with the intact (11.3 +/- 4.1) or posterior wall-denervated (12.6 +/- 3.2) group. An additional group of ventricular-denervated dogs was studied to determine the effects of sequential, brief 2-min CAO at 2, 4, and 8 wk after denervation. Responses of regional wall thickening to CAO were not affected significantly even after 8 wk following ventricular denervation. Thus, in conscious dogs, neither selective ventricular denervation nor selective denervation of the posterior LV wall improved collateral blood flow, affected regional function favorably, or reduced infarct size after CAO.

摘要

心脏去神经支配对心肌缺血反应的影响程度仍存在争议。本研究比较了三组清醒犬在24小时冠状动脉闭塞(CAO)时,在以下指标上的反应:壁厚度测量(超声晶体)、局部心肌血流量(微球)和梗死面积(三苯基四氮唑氯化物技术),这三组犬分别为:1)选择性左心室后壁去神经支配;2)选择性心室去神经支配;3)完整的犬。CAO后,三组之间的血流动力学变化无差异。缺血区的壁增厚在CAO后早期即变为运动不能或矛盾运动,且在24小时监测期内任何一组均未恢复。所有组中,危险区域的血流量下降相似。梗死面积占危险区域的百分比,完整组为45±7%,左心室后壁去神经支配组为48±6%,心室去神经支配组为48±8%。然而,与完整组(11.3±4.1)或后壁去神经支配组(12.6±3.2)相比,心室去神经支配组在CAO 3小时后每分钟心律失常的频率较低(P<0.05)(3.2±1.4)。另外一组心室去神经支配的犬被用于研究去神经支配后2、4和8周时,连续2分钟短暂CAO的影响。即使在心室去神经支配8周后,局部壁增厚对CAO的反应仍未受到显著影响。因此,在清醒犬中,选择性心室去神经支配或左心室后壁选择性去神经支配均不能改善侧支血流,对局部功能无有利影响,也不能在CAO后减少梗死面积。

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