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急性缺血犬心肌中9微米和15微米示踪微球的早期分流

Early shunting of 9 microns and 15 microns tracer microspheres from the acutely ischemic canine myocardium.

作者信息

Meesmann W, von Krosigk S, Neumann M, Martin C, Hirche H, Horacek T, Sautter R, Budden M

出版信息

Basic Res Cardiol. 1983 May-Jun;78(3):310-25. doi: 10.1007/BF01907440.

Abstract

Recent reports have shown considerably differing results for myocardial shunting of 9 microns and 15 microns tracer microspheres (TMs) under various conditions. This could restrict the use of TMs for myocardial, especially collateral blood flow measurements. To determine the importance of coronary collateral blood flow and its early changes during the first 30 minutes after acute coronary artery occlusion (i.e. the 1st arrhythmic phase), we studied the shunting of 9 microns and 15 microns TMs from the ischemic myocardium during acute LAD ligation. In anesthetized dogs these TMs and subsequently Ringer solution were infused into the occluded coronary artery just distal to the ligation with constant low perfusion pressure. TM shunting (%S) into the lungs was then determined (%S = total lung radioactivity . 100/radioactivity infused). During a single LAD occlusion lasting 35 minutes (series I, n = 10) 9 microns TMs were infused immediately and 30 minutes after ligation, 15 microns TMs being infused after 15-20 minutes. In series II (n = 6) 9 microns TMs were infused immediately during the 1st, short (5 minutes) LAD occlusion. Following 90 minutes of reperfusion a 2nd LAD ligation (35 minutes) was performed with 9 microns TMs being infused immediately and 30 minutes after occlusion. During the first 30 minutes of acute coronary artery occlusion, TM shunting from the ischemic myocardium is negligible for 15 microns TMs (%S less than 0.5%; n = 5), whereas the mean 9 microns TM shunt of the early applied TM (i.e. A1, series I; n = 9; B2, series II; n = 6) amounts to a maximum of 1.21 +/- 0.2% (X +/- SEM). After 30 minutes of occlusion the mean 9 microns TM shunt amounts only to 0.71 +/- 0.15% (i.e. C1, series I; n = 4; C2, series II; n = 4). - In a coronary artery occlusion repeated once, 9 microns TM shunting, while increasing slightly due to the 90 minutes of reperfusion, still amounts to only 1.73 +/- 0.41% (n = 6). In three experiments 9 microns TMs were infused into the unoccluded, normally perfused LCX coronary artery during LAD occlusion. The mean LCX shunt value of 4% after a mean time of 25 minutes following TM infusion is in very good agreement with the 9 microns TM shunt values in the literature. These results clearly demonstrate that the TM technique with 9 microns microspheres is suitable for measuring changes in coronary collateral blood flow at least for a short time period after acute coronary artery occlusion.

摘要

近期报告显示,在各种条件下,9微米和15微米示踪微球(TMs)的心肌分流结果存在显著差异。这可能会限制TMs在心肌,尤其是侧支血流测量中的应用。为了确定急性冠状动脉闭塞后最初30分钟内(即第一个心律失常期)冠状动脉侧支血流的重要性及其早期变化,我们研究了急性左前降支(LAD)结扎期间缺血心肌中9微米和15微米TMs的分流情况。在麻醉的犬中,将这些TMs以及随后的林格溶液以恒定的低灌注压力注入结扎部位远端的闭塞冠状动脉。然后测定进入肺部的TM分流率(%S)(%S = 肺总放射性. 100/注入的放射性)。在单次持续35分钟的LAD闭塞期间(系列I,n = 10),在结扎后立即注入9微米TMs,30分钟后注入15微米TMs,15 - 20分钟后注入15微米TMs。在系列II(n = 6)中,在第一次短暂(5分钟)的LAD闭塞期间立即注入9微米TMs。在再灌注90分钟后进行第二次LAD结扎(35分钟),在闭塞后立即和30分钟后注入9微米TMs。在急性冠状动脉闭塞的最初30分钟内,对于15微米TMs,从缺血心肌的TM分流可忽略不计(%S小于0.5%;n = 5),而早期应用的9微米TMs的平均分流率(即系列I中的A1;n = 9;系列II中的B2;n = 6)最高可达1.21 +/- 0.2%(X +/- SEM)。闭塞30分钟后,9微米TMs的平均分流率仅为0.71 +/- 0.15%(即系列I中的C1;n = 4;系列II中的C2;n = 4)。 - 在重复一次冠状动脉闭塞的实验中,9微米TMs的分流虽因90分钟的再灌注而略有增加,但仍仅为1.73 +/- 0.41%(n = 6)。在三个实验中,在LAD闭塞期间将9微米TMs注入未闭塞、正常灌注的左旋支冠状动脉。注入TMs后平均25分钟时,左旋支的平均分流值为4%,与文献中9微米TMs的分流值非常吻合。这些结果清楚地表明,至少在急性冠状动脉闭塞后的短时间内,9微米微球的TM技术适用于测量冠状动脉侧支血流的变化。

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