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持续1至120分钟的冠状动脉闭塞后局部功能的时间进程。

Time course of regional function after coronary occlusions of 1- to 120-min duration.

作者信息

Darsee J R, Kloner R A, Braunwald E

出版信息

Am J Physiol. 1981 Mar;240(3):H399-407. doi: 10.1152/ajpheart.1981.240.3.H399.

Abstract

The purpose of this study was to characterize the degree and duration of functional impairment in previously ischemic tissue following coronary artery occlusions of varying duration. Open-chest dogs with left ventricular pressure transducers and ultrasonic segment length crystals were subjected to coronary artery occlusions of 1 (n = 22), 5 (n = 8), 10 (n = 7), 15 (n = 8), 20 (n = 7), 30 (n = 6), 60 (n = 10), or 120 (n = 8) min and segment length motion was measured during 6 h of reperfusion. Active shortening was replaced by passive lengthening during coronary occlusion and regional myocardial blood flow within the ischemic zone was always less than 0.4 ml . min-1 . g-1. Following reperfusion, the improvement of ischemic segment length function was inversely proportional to the duration of coronary occlusion. Function in previously ischemic segment lengths recovered rapidly after 1- and 5-min coronary occlusions, but after occlusions of 10-20 min, there was slow, though incomplete, return of some degree of active shortening yet no evidence of myocardial infarction. With occlusions exceeding 20 min there was persistence of systolic passive lengthening for 6 h despite the absence of infarction in the segment lengths in which function was being evaluated, although infarcted tissue was present ranging from 16.5 +/- 2.6% of the area of ischemia in dogs with 60-min coronary occlusions to 37.2 +/- 4.6% of the area of ischemia in dogs with 120-min occlusions.

摘要

本研究的目的是描述在冠状动脉不同时长闭塞后,先前缺血组织功能障碍的程度和持续时间。对安装了左心室压力传感器和超声节段长度晶体的开胸犬进行1(n = 22)、5(n = 8)、10(n = 7)、15(n = 8)、20(n = 7)、30(n = 6)、60(n = 10)或120(n = 8)分钟的冠状动脉闭塞,并在再灌注6小时期间测量节段长度运动。冠状动脉闭塞期间主动缩短被被动延长所取代,缺血区内的局部心肌血流量始终小于0.4 ml·min-1·g-1。再灌注后,缺血节段长度功能的改善与冠状动脉闭塞的持续时间成反比。在冠状动脉闭塞1分钟和5分钟后,先前缺血节段长度的功能迅速恢复,但在闭塞10 - 20分钟后,虽然有一定程度的主动缩短缓慢但不完全恢复,且没有心肌梗死的证据。闭塞超过20分钟时,尽管在评估功能的节段长度中没有梗死,但收缩期被动延长持续6小时,不过在冠状动脉闭塞60分钟的犬中,梗死组织占缺血面积的16.5±2.6%,在冠状动脉闭塞120分钟的犬中,梗死组织占缺血面积的37.2±4.6%。

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