Kyo S, Emoto H, Yamanaka H, Takamoto S, Yokote Y, Omoto R, Buckley M J, Austen W G
Jpn Circ J. 1984 Mar;48(3):266-75. doi: 10.1253/jcj.48.266.
Dynamic patch artificial myocardium (D-PATCH) has been developed to replace the damaged left ventricular (LV) wall in severe cardiogenic shock patients with a massive myocardial infarction. This study was undertaken to demonstrate the effects of (1) single D-PATCH support on the global cardiac function (group 1, 12 dogs, whole heart model), (2) single D-PATCH support on the LV function and myocardial metabolism (group 2, 6 dogs, right heart bypass model), and (3) the concomitant support of D-PATCH and aortic counterpulsation (CP) on the regional myocardial function of the residual LV wall (group 3, 6 dogs, right heart bypass model with ultrasonic piezoelectric crystals). In group 1, mean aortic pressure and cardiac output were increased 20-36% (p less than 0.01) and 17-50% (p less than 0.01) respectively, and mean left atrial pressure was decreased 16% (p less than 0.01) by D-PATCH assist. In group 2, under constant preload volume, afterload pressure and heart rate, tension time index (TTI) was decreased 21-26% (p less than 0.01) and myocardial oxygen consumption was also decreased 24-29% (p less than 0.001) by D-PATCH assist. In group 3, although peak LVP was increased by single D-PATCH assist, when heart was assisted concomitantly by D-PATCH and CP peak LVP was significantly decreased (18%, p less than 0.01). Percent LV segmental shortening was not increased by CP assist, but increased 143% (p less than 0.02) by D-PATCH assist. In conclusion, D-PATCH can improve the global LV function and myocardial metabolism of the ischemic failing heart, also improve the regional myocardial function of the residual LV wall. Thus, D-PATCH is effective for the salvage of ischemic myocardium while maintaining the global cardiac function.
动态贴片人工心肌（D-PATCH）已被开发用于替代患有大面积心肌梗死的严重心源性休克患者受损的左心室（LV）壁。本研究旨在证明：（1）单个D-PATCH支持对整体心脏功能的影响（第1组，12只犬，全心模型）；（2）单个D-PATCH支持对左心室功能和心肌代谢的影响（第2组，6只犬，右心旁路模型）；以及（3）D-PATCH和主动脉反搏（CP）联合支持对残余左心室壁区域心肌功能的影响（第3组，6只犬，带有超声压电晶体的右心旁路模型）。在第1组中，D-PATCH辅助使平均主动脉压和心输出量分别增加了20 - 36%（p < 0.01）和17 - 50%（p < 0.01），平均左心房压降低了16%（p < 0.01）。在第2组中，在恒定的前负荷量、后负荷压力和心率下，D-PATCH辅助使张力时间指数（TTI）降低了21 - 26%（p < 0.01），心肌耗氧量也降低了24 - 29%（p < 0.001）。在第3组中，虽然单个D-PATCH辅助使左心室峰值压力（LVP）升高，但当心脏同时接受D-PATCH和CP辅助时，LVP峰值显著降低（18%，p < 0.01）。CP辅助并未增加左心室节段缩短百分比，但D-PATCH辅助使其增加了143%（p < 0.02）。总之，D-PATCH可改善缺血性衰竭心脏的整体左心室功能和心肌代谢，还可改善残余左心室壁的区域心肌功能。因此，D-PATCH在维持整体心脏功能的同时对挽救缺血心肌有效。
