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清醒犬不同程度心肌缺血时非缺血节段缩短的特征分析

Characterization of nonischemic segment shortening during variable extent of myocardial ischemia 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 65211.

出版信息

Heart Vessels. 1987;3(3):122-8. doi: 10.1007/BF02058787.

Abstract

Studies were performed on seven conscious dogs chronically instrumented for measurement of subendocardial segment length in the central area perfused by the left circumflex coronary artery (LCCA) and left anterior descending coronary artery, LCCA flow, and left ventricular pressure. We occluded the LCCA for 2 min using an externally inflatable pneumatic occluder placed around the proximal LCCA. Two-minute LCCA occlusions were repeated hourly for 8 h, 5 days/week. The first LCCA occlusion decreased the ejection phase shortening in the ischemic area from 22.2% +/- 2.5% (SEM) to 3.1% +/- 0.7% (P less than 0.001). Concomitantly, heart rate increased from a resting rate of 76 +/- 4 to 117 +/- 6 beats/min (P less than 0.001) after 2 min of LCCA occlusion, and ejection phase shortening in the nonischemic area decreased from 25.5% +/- 1.3% to 21.6% +/- 1.1% (P less than 0.001) despite increases in end-diastolic segment length (15.31 +/- 1.46 mm to 15.69 +/- 1.52 mm, P less than 0.01). These changes in non-ischemic segment shortening and heart rate during LCCA occlusion were attenuated progressively with improvement tin the regional myocardial function at jeopardy due to the development of collateral circulation, and a significant (P less than 0.001) correlation between both the reduced nonischemic segment shortening and the increased heart rate with the degree of dysfunction in the ischemic region was obtained by linear regression analysis with Fisher's Z transformation.

摘要

对7只清醒犬进行了研究,这些犬长期植入仪器,用于测量左旋冠状动脉(LCCA)和左前降支冠状动脉灌注的中心区域的心内膜下节段长度、LCCA血流量和左心室压力。我们使用围绕LCCA近端放置的外部可充气气动闭塞器将LCCA闭塞2分钟。以每小时1次的频率重复进行2分钟的LCCA闭塞,共持续8小时,每周5天。首次LCCA闭塞使缺血区域的射血期缩短率从22.2%±2.5%(标准误)降至3.1%±0.7%(P<0.001)。同时,LCCA闭塞2分钟后,心率从静息时的76±4次/分钟增加到117±6次/分钟(P<0.001),非缺血区域的射血期缩短率从25.5%±1.3%降至21.6%±1.1%(P<0.001),尽管舒张末期节段长度有所增加(从15.31±1.46毫米增加到15.69±1.52毫米,P<0.01)。由于侧支循环的发展,LCCA闭塞期间非缺血节段缩短和心率的这些变化随着濒危区域心肌功能的改善而逐渐减弱,通过Fisher Z变换的线性回归分析发现,非缺血节段缩短的减少和心率的增加与缺血区域功能障碍程度之间存在显著(P<0.001)相关性。

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