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猪冠状动脉侧支结构、功能及缺血边缘区分析。

Analysis of coronary collateral structure, function, and ischemic border zones in pigs.

作者信息

Patterson R E, Kirk E S

出版信息

Am J Physiol. 1983 Jan;244(1):H23-31. doi: 10.1152/ajpheart.1983.244.1.H23.

Abstract

The purpose of this study was to compare coronary collateral structure and function in pigs with those in dogs and to analyze the distribution of collateral blood flow across the lateral and transmural border zones in the pig. After acute occlusion of the left anterior descending coronary artery (LAD) in 26 anesthetized open-chest pigs, minimal collateral blood flow was indicated by retrograde flow (0.2 +/- 0.1 ml/min) and microsphere-myocardial blood flow (0.005 +/- 0.001 ml X min-1g-1). Postmortem injection of the distal LAD followed by clearance of the heart demonstrated few tiny collateral structures and negligible collateral filling of other arteries. In contrast to dogs, pigs showed no measurable gradient of collateral blood flow across the transmural border zone, and pigs showed no change in collateral blood flow or its transmural distribution during retrograde drainage of collateral blood flow or elevated left ventricular filling pressures. Pigs showed higher myocardial blood flow in the lateral border than in the center of the ischemic zone. As in the dog, however, this gradient of blood flow across the lateral border zone was accounted for by overlap between occluded LAD branches and unoccluded coronary arterial branches rather than by preferential collateral perfusion of the lateral border of the ischemic zone. We conclude that the pig has a homogeneous distribution of collateral blood flow across the transmural and lateral border zones after acute coronary occlusion but that the minimal collateral circulation limits the usefulness of the pig as a model of ischemic heart disease.

摘要

本研究的目的是比较猪与犬的冠状动脉侧支结构和功能,并分析侧支血流在猪心脏侧壁和透壁边界区的分布情况。在26只麻醉开胸猪的左前降支冠状动脉(LAD)急性闭塞后,逆行血流(0.2±0.1 ml/min)和微球-心肌血流(0.005±0.001 ml·min⁻¹·g⁻¹)提示侧支血流极少。在心脏清除后经LAD远端进行尸检注射,结果显示侧支结构微小,其他动脉的侧支充盈可忽略不计。与犬不同,猪在透壁边界区未显示出可测量的侧支血流梯度,并且在侧支血流逆行引流或左心室充盈压升高期间,猪的侧支血流及其透壁分布没有变化。猪缺血区侧壁的心肌血流高于中心区。然而,与犬一样,这种跨侧壁边界区的血流梯度是由闭塞的LAD分支与未闭塞的冠状动脉分支重叠所致,而非缺血区侧壁的侧支优先灌注。我们得出结论,急性冠状动脉闭塞后,猪的侧支血流在透壁和侧壁边界区分布均匀,但侧支循环极少限制了猪作为缺血性心脏病模型的实用性。

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