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氨茶碱对冠脉闭塞后清醒犬的作用。

Effects of aminophylline in the conscious dog after coronary occlusion.

作者信息

Rutherford J D, Vatner S F, Braunwald E

出版信息

Am J Cardiol. 1981 Dec;48(6):1071-6. doi: 10.1016/0002-9149(81)90322-2.

Abstract

The effects of aminophylline were examined in 19 conscious dogs subjected to coronary arterial occlusion. Measurements were made of left ventricular pressure and its first derivative (dP/dt), segment length and the velocity of segment length shortening in normal an severely ischemic zones. Regional blood flow was measured in these zones using the radioactive microsphere technique. Coronary occlusion increased heart rate, mean arterial pressure and left ventricular end-diastolic pressure but did not change left ventricular systolic pressure or dP/dt significantly. It also resulted in increased end-diastolic segment length and reduced segment length shortening (114 +/- 6 percent, that is, paradoxical bulging) associated with marked reduction of blood flow to ischemic myocardium. Aminophylline, 1 mg/kg per min for 9 to 15 minutes administered after occlusion, increased heart rate 6 +/- 2 beats/min, mean arterial pressure 5 +/- 1 mm Hg, left ventricular systolic pressure 9 +/- 2 mm Hg and left ventricular dP/dt 670 +/- 50 mm Hg/s while reducing left ventricular end-diastolic pressure by 3.4 +/- 0.3 mm Hg. In severely ischemic zones aminophylline increased transmural blood flow by 21 +/- 8.0 percent (p less than 0.02), reduced end-diastolic segment length by 0.23 +2- 0.05 mm (p less than 0.01) and reduced paradoxical bulging by 0.15 +/- 0.06 mm (p less than 0.02). Thus, in the presence of coronary arterial occlusion, aminophylline increased mean arterial pressure, left ventricular dP/dt and heart rate while reducing left ventricular end-diastolic pressure. In severely ischemic myocardium aminophylline appeared to exert a salutary effect and improved both regional perfusion and function.

摘要

在19只清醒的冠状动脉闭塞犬身上研究了氨茶碱的作用。测量了正常和严重缺血区域的左心室压力及其一阶导数(dP/dt)、节段长度和节段长度缩短速度。使用放射性微球技术测量这些区域的局部血流量。冠状动脉闭塞增加了心率、平均动脉压和左心室舒张末期压力,但对左心室收缩压或dP/dt没有显著影响。它还导致舒张末期节段长度增加,节段长度缩短减少(114±6%,即矛盾性膨出),同时缺血心肌的血流量显著减少。闭塞后以每分钟1mg/kg的剂量给予氨茶碱9至15分钟,使心率增加6±2次/分钟,平均动脉压增加5±1mmHg,左心室收缩压增加9±2mmHg,左心室dP/dt增加670±50mmHg/s,同时左心室舒张末期压力降低3.4±0.3mmHg。在严重缺血区域,氨茶碱使透壁血流量增加21±8.0%(p<0.02),舒张末期节段长度减少0.23±0.05mm(p<0.01),矛盾性膨出减少0.15±0.06mm(p<0.02)。因此,在冠状动脉闭塞的情况下,氨茶碱增加了平均动脉压、左心室dP/dt和心率,同时降低了左心室舒张末期压力。在严重缺血的心肌中,氨茶碱似乎发挥了有益作用,改善了局部灌注和功能。

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