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缺血心肌外侧缘的区域功能与灌注

Regional function and perfusion at the lateral border of ischemic myocardium.

作者信息

Homans D C, Asinger R, Elsperger K J, Erlien D, Sublett E, Mikell F, Bache R J

出版信息

Circulation. 1985 May;71(5):1038-47. doi: 10.1161/01.cir.71.5.1038.

Abstract

To determine whether function is depressed in areas of myocardium adjacent to an area of myocardial ischemia, 16 open-chest dogs were studied with both two-dimensional echocardiography and ultrasonic microcrystals. Regional myocardial blood flow was measured with radioactive microspheres during control periods and after coronary arterial ligation. Segments of myocardium adjacent to the area of ischemia were found to have no significant change in transmural blood flow (1.02 +/- 0.38 ml/g/min control vs 0.95 +/- 0.3 ml/g/min after ligation) or subendocardial flow (1.18 +/- 0.41 ml/g/min control vs. 1.19 +/- 0.37 ml/g/min after ligation). Regional function assessed echocardiographically as percent change in segment area was significantly depressed in these normally perfused adjacent areas (69.5 +/- 18.8% control vs 52.5 +/- 19.8% after ligation; p less than .01). There was a significant relationship between proximity to border of infarction and degree of adjacent dysfunction (r = .50, p less than .01 for echocardiography; r = .70, p less than .01 for ultrasonic microcrystals). It is concluded that systolic performance is depressed in nonischemic myocardium directly adjacent to the lateral border of an area of acute myocardial ischemia.

摘要

为了确定心肌缺血区域附近心肌区域的功能是否降低,对16只开胸犬进行了二维超声心动图和超声微晶研究。在对照期和冠状动脉结扎后,用放射性微球测量局部心肌血流量。发现缺血区域附近的心肌节段透壁血流量(对照期为1.02±0.38ml/g/min,结扎后为0.95±0.3ml/g/min)或心内膜下血流量(对照期为1.18±0.41ml/g/min,结扎后为1.19±0.37ml/g/min)无显著变化。在这些正常灌注的相邻区域,通过超声心动图评估的区域功能以节段面积变化百分比表示显著降低(对照期为69.5±18.8%,结扎后为52.5±19.8%;p<0.01)。梗死边界的接近程度与相邻功能障碍程度之间存在显著关系(超声心动图r = 0.50,p<0.01;超声微晶r = 0.70,p<0.01)。结论是,急性心肌缺血区域外侧边界直接相邻的非缺血心肌的收缩功能降低。

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