Walfridsson H, Lewis D H, Sjöberg F, Lund N
Int J Microcirc Clin Exp. 1985;4(2):109-20.
The area between ischemic and normal myocardium after acute coronary occlusion-the border zone-is of great interest. It has been proposed that this area contains reversibly damaged myocardium subjectable to myocardial salvage. Twenty Swedish land race pigs were studied, 13 after acute occlusion of the left anterior descending coronary artery (LAD), while seven served as controls. We measured tissue oxygen pressures (ptO2) subepicardially with the MDO electrode. This is a multiwire surface electrode measuring ptO2 with eight individual platinum wires. Hundred and twenty values were collected in each measuring situation. The electrode was positioned on the lateral border zone, measurements were performed before and 5, 30 and 120 min after LAD occlusion. In five cases successful measurements were performed across the border zone. A mixture of normal and ischemic ptO2 values was found 5 min after occlusion. After 30 min of occlusion the number of ischemic values decreased and this was particularly the case after two hours of occlusion. The results support the view that the border zone was very narrow. The reduced number of ischemic values after two hours of permanent LAD occlusion also indicated that the border zone may be narrow but not necessarily fixed but instead dynamic. In this case there was a spontaneous decrease of the ischemic area.
急性冠状动脉闭塞后缺血心肌与正常心肌之间的区域——边缘区——备受关注。有人提出该区域包含可进行心肌挽救的可逆性损伤心肌。对20头瑞典长白猪进行了研究,其中13头在左前降支冠状动脉(LAD)急性闭塞后进行观察,7头作为对照。我们使用MDO电极在心外膜下测量组织氧分压(ptO2)。这是一种多线表面电极,通过8根独立的铂丝测量ptO2。在每种测量情况下收集120个值。电极置于外侧边缘区,在LAD闭塞前以及闭塞后5分钟、30分钟和120分钟进行测量。在5例中成功地在整个边缘区进行了测量。闭塞后5分钟发现正常和缺血ptO2值混合存在。闭塞30分钟后,缺血值数量减少,闭塞两小时后尤其如此。结果支持边缘区非常狭窄这一观点。LAD永久性闭塞两小时后缺血值数量减少也表明边缘区可能狭窄,但不一定是固定不变的,而是动态变化的。在这种情况下,缺血区域出现了自发缩小。