Savage R M, Guth B, White F C, Hagan A D, Bloor C M
Circulation. 1981 Oct;64(4):699-707. doi: 10.1161/01.cir.64.4.699.
Regional myocardial function and blood flow were determined for 48 hours after permanent occlusion of the left circumflex coronary artery in conscious swine. Systolic wall thickening and end-diastolic wall thickness (EDWTh) were correlated with regional myocardial flow (RMBF) at 15 minutes, 24 and 48 hours after occlusion. Both regional function and blood flow were compared with the extent of myocardial necrosis (determined histologically) after 48 hours in functionally distinct zones. Group 1 (control zones) was characterized by increased systolic wall thickening, EDWTh, RMBF and had no necrosis. Group 2 (marginal zones) had depressed systolic wall thickening (35 +/- 3% [mean +/ SEM] of preocclusion level at 48 hours) and RMBF (64 +/- 6% of preocclusion values), transiently decreased EDWTh and 46 +/- 5% necrosis. In Group 3 (ischemic zones), all values were greatly reduced: systolic wall thickening was 3.6 +/- 1.2%, EDWTh 76 +/- 8% and RMBF 25 +/- 9% preocclusion values; necrosis was 90 +/- 5%. Groups 2 and 3 had increased RMBF at 24 and 48 hours from that at 15 minutes after occlusion; however, in neither case was systolic wall thickening greater than that at 15 minutes after occlusion. We conclude that there is close correlation between RMBF, systolic wall thickening and the extent of necrosis present after 48 hours of coronary artery occlusion in the conscious swine; subsequent increases in RMBF to the marginal zone after occlusion are not accompanied by improved regional function.
在清醒猪身上,于左旋冠状动脉永久闭塞后48小时测定局部心肌功能和血流。在闭塞后15分钟、24小时和48小时,收缩期室壁增厚和舒张末期室壁厚度(EDWTh)与局部心肌血流(RMBF)相关。在功能不同的区域,48小时后将局部功能和血流与心肌坏死程度(通过组织学确定)进行比较。第1组(对照区)的特征是收缩期室壁增厚、EDWTh、RMBF增加且无坏死。第2组(边缘区)收缩期室壁增厚降低(48小时时为闭塞前水平的35±3%[平均值±标准误]),RMBF降低(为闭塞前值的64±6%),EDWTh短暂降低,坏死率为46±5%。在第3组(缺血区),所有值均大幅降低:收缩期室壁增厚为3.6±1.2%,EDWTh为76±8%,RMBF为闭塞前值的25±9%;坏死率为90±5%。第2组和第3组在闭塞后24小时和48小时的RMBF高于闭塞后15分钟时;然而,在这两种情况下,收缩期室壁增厚均未大于闭塞后15分钟时。我们得出结论,在清醒猪冠状动脉闭塞48小时后,RMBF、收缩期室壁增厚与坏死程度之间存在密切相关性;闭塞后边缘区RMBF随后的增加并未伴随局部功能的改善。