Case R B, Felix A, Castellana F S
Circ Res. 1979 Sep;45(3):324-30. doi: 10.1161/01.res.45.3.324.
We have investigated the rate of rise of myocardial PCO2 (PmCO2) after coronary artery occlusion using a new method for this measurement. Previous studies of PmCO2 have been limited by the slow response of the only available method, and no increase in MmCO2 prior to 3 minutes after occlusion has been found. We have implanted a miniature PCO2 electrode, with a 63% response time of 14 seconds, into the left ventricle of 14 open-chest dogs. After abrupt coronary occlusion, PmCO2 began to rise in 13.6 +/- 1.1 seconds in heparinized dogs and in 7.5 +/- 0.7 seconds in unheparinized dogs. The subsequent magnitude of the increase in PmCO2 was 24, 88, 171, and 222 mm Hg at 2, 5, 10, and 15 minutes after occlusion. The rate of rise of PmCO2 was essentially linear from 1 minute to 10 minutes at a rate of 18.3 mm Hg/min. The rate of rise was slower during the first 30 seconds after occlusion (6.1 mm Hg/min) and also from 30 seconds to 1 minute (9.7 mm Hg/min). This rate of rise is much greater than that previously observed and reflects the severe myocardial acidosis developing during ischemia. A rise in PmCO2 is one of the earliest metabolic changes that has been observed during myocardial ischemia.
我们使用一种新的测量方法研究了冠状动脉闭塞后心肌二氧化碳分压(PmCO2)的上升速率。以往对PmCO2的研究受到唯一可用方法响应缓慢的限制,并且在闭塞后3分钟之前未发现PmCO2升高。我们将响应时间为14秒(63%)的微型二氧化碳电极植入14只开胸犬的左心室。冠状动脉突然闭塞后,肝素化犬的PmCO2在13.6±1.1秒开始上升,未肝素化犬在7.5±0.7秒开始上升。闭塞后2、5、10和15分钟,PmCO2随后升高的幅度分别为24、88、171和222 mmHg。PmCO2的上升速率在1分钟至10分钟基本呈线性,速率为18.3 mmHg/分钟。闭塞后最初30秒内上升速率较慢(6.1 mmHg/分钟),在30秒至1分钟内也是如此(9.7 mmHg/分钟)。这种上升速率比之前观察到的要大得多,反映了缺血期间发生的严重心肌酸中毒。PmCO2升高是心肌缺血期间最早观察到的代谢变化之一。