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[急性实验性心肌缺血时晚期心室电位的表现]

[Behavior of late ventricular potentials in acute experimental myocardial ischemia].

作者信息

Duck H J, Pankau H, Köhler H

出版信息

Z Gesamte Inn Med. 1985 Jun 1;40(11):310-8.

PMID:4036207
Abstract

Locally retarded depolarizations of the ischaemic myocardium are regarded as frequent trigger mechanisms of dangerous ventricular arrhythmias. Up to now, however, there are scarcely systematic investigations concerning their concrete developmental conditions in man, since late potentials can be made evident only by means of expensive invasive methods or signal mediation techniques. Therefore, an animal model should be built, which is suitable for the control of new therapy conceptions with antiarrhythmic drugs. The investigations were performed on 22 pigs in whom under insufflation anaesthesia altogether 10 pressure, flow and contractility parameters as well as 6 epicardial ECG signals were continuously recorded. The episodes of ischaemia were caused by LAD occlusions of different duration and intensity. Typical late potentials could be registered in 5 animals who all had survived complete interruptions of the coronary blood flow of longer than 10 min. The mean duration of the late potentials was 20 +/- 9.2 ms, their amplitudes reached from 150 to 600 microV. Also with regard to time and cycle constancy, the delay of the late Q-potential and the morphology they corresponded to the homogeneous phenomenon, known from man. They always could be derived only from electrodes outside the immediate zone of ischaemia. Neither partial occlusions nor complete interruption of the coronary blood flow in intervals shorter than 10 minutes led to the development of a late potential. The animal model used altogether appears very suitable to investigate the medicamentous influencibility of arrhythmogenic areas of the myocardium under direct control of the dynamic behaviour of ventricular late potentials.

摘要

缺血心肌的局部延迟去极化被认为是危险室性心律失常常见的触发机制。然而,到目前为止,关于它们在人体中的具体发展情况几乎没有系统的研究,因为晚期电位只能通过昂贵的侵入性方法或信号介导技术才能显现出来。因此,应该建立一种动物模型,适合用于控制抗心律失常药物新治疗理念的研究。对22头猪进行了研究,在吹入麻醉下,连续记录了总共10个压力、流量和收缩力参数以及6个心外膜心电图信号。缺血发作是由不同持续时间和强度的左前降支闭塞引起的。在5只动物中记录到了典型的晚期电位,这些动物均在冠状动脉血流完全中断超过10分钟后存活下来。晚期电位的平均持续时间为20±9.2毫秒,其幅度在150至600微伏之间。在时间和周期稳定性方面,晚期Q电位的延迟及其形态与从人类已知的同质现象相符。它们总是只能从缺血直接区域之外的电极获得。冠状动脉血流的部分闭塞或在短于10分钟的间隔内完全中断均未导致晚期电位的出现。所使用的动物模型总体上似乎非常适合在心室晚期电位动态行为的直接控制下,研究心肌致心律失常区域的药物可影响性。

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