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猪和狗急性冠状动脉闭塞后缺血心肌外侧缘侧支血流的分布情况。

Distribution of the collateral blood flow at the lateral border of the ischemic myocardium after acute coronary occlusion in the pig and the dog.

作者信息

Sjöquist P O, Duker G, Almgren O

出版信息

Basic Res Cardiol. 1984 Mar-Apr;79(2):164-75. doi: 10.1007/BF01908303.

Abstract

Residual blood flow in pigs (n = 8) and dogs (n = 11) was measured by tracer microspheres (85Sr) 1 hour after occlusion of the left anterior descending coronary artery (LAD). Collateral blood flow was distinguished from overlap flow, defined as the blood flow of non-ischemic myocardium interdigitating into the ischemic area, by direct LAD injection of isotope-labelled microspheres (125I) prior to ligation. In the center of the acutely ischemic pig myocardium the residual blood flow, i.e., the myocardial perfusion remaining after LAD occlusion, was 0.01 +/- 0.01 ml/min/g subendocardially and 0.02 +/- 0.01 ml/min/g subepicardially , as estimated with 85Sr-labelled microspheres. These values were significantly lower than the corresponding values for the dog, 0.13 +/- 0.05 ml/min/kg (p less than 0.05) subendocardially and 0.28 +/- 0.08 ml/min/g (p less than 0.01) subepicardially . In the lateral aspects of the ischemic area, calculations of overlap flow were made with the aid of the distribution of the microspheres injected into the LAD. Values of the residual blood flow were normalized and non-ischemic myocardial perfusion was set to 100 units. In subepicardial layers of the myocardium with calculated overlap flows corresponding to 20, 50 or 80 units, respectively, the residual blood flow (overlap flow + collateral flow) actually measured in the pig was 31 +/- 4, 55 +/- 4 and 75 +/- 7 units and in the dog 65 +/- 6, 79 +/- 5 and 91 +/- 2 units. The values for the dog were significantly different from the respective value for the pig (p less than 0.01). In the subendocardial layers the difference between the two species regarding residual blood flow was similar, although the difference was statistically significant only for myocardium with a calculated overlap flow of 80 units. When the calculated overlap flow was subtracted from the measured residual blood flow, the collateral blood flow was found to be extensive in the dog and virtually absent in the pig. When, in the dog, the collateral blood flow across the lateral border of the ischemic area was related to the amount of myocardium it supplies, it was found to be homogeneously distributed. Thus neither subendocardially nor subepicardially could a gradient of collateral blood flow be detected. It is concluded that in the pig the collateral blood flow is almost nil throughout the acutely ischemic myocardium, both in subendocardial and subepicardial layers. In contrast, the dog has an extensive collateral flow. No lateral gradient of this collateral blood flow could, however, be detected.

摘要

在猪(n = 8)和狗(n = 11)身上,于左冠状动脉前降支(LAD)闭塞1小时后,通过示踪微球(85Sr)测量残余血流。在结扎前通过直接向左冠状动脉前降支注射同位素标记的微球(125I),将侧支血流与重叠血流区分开来,重叠血流定义为穿插进入缺血区域的非缺血心肌的血流。在用85Sr标记的微球估算时,急性缺血猪心肌中心的残余血流,即左冠状动脉前降支闭塞后剩余的心肌灌注,心内膜下为0.01±0.01ml/(min·g),心外膜下为0.02±0.01ml/(min·g)。这些值显著低于狗的相应值,心内膜下为0.13±0.05ml/(min·kg)(p<0.05),心外膜下为0.28±0.08ml/(min·g)(p<0.01)。在缺血区域的外侧,借助注入左冠状动脉前降支的微球分布计算重叠血流。将残余血流值进行归一化处理,并将非缺血心肌灌注设定为100个单位。在心肌的心外膜下层,计算出的重叠血流分别对应20、50或80个单位,猪实际测量的残余血流(重叠血流+侧支血流)分别为31±4、55±4和75±7个单位,狗为65±6、79±5和91±2个单位。狗的值与猪的相应值有显著差异(p<0.01)。在心内膜下层,两种动物在残余血流方面的差异类似,尽管仅在计算出的重叠血流为80个单位的心肌中差异具有统计学意义。当从测量的残余血流中减去计算出的重叠血流时,发现狗的侧支血流丰富,而猪几乎没有。在狗身上,当跨越缺血区域外侧边界的侧支血流与它所供应的心肌量相关时,发现其分布均匀。因此,在心内膜下和心外膜下均未检测到侧支血流梯度。结论是,在猪急性缺血心肌的心内膜下和心外膜下层,侧支血流几乎为零。相比之下,狗有丰富的侧支血流。然而,未检测到这种侧支血流的外侧梯度。

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