Gallagher K P, Kumada T, Koziol J A, McKown M D, Kemper W S, Ross J
Circulation. 1980 Dec;62(6):1266-74. doi: 10.1161/01.cir.62.6.1266.
In 15 open-chest, anesthetized dogs, regional systolic wall thickening (% delta WT) was measured with sonomicrometry and regional blood flow was determined with tracer microspheres (7-10 micron) before and after various degrees of coronary artery narrowing were created with a hydraulic occluder. The stenoses were categorized into four groups by the effect on % delta WT, and the corresponding myocardial blood flow (MBF) was determined in four layers across the ventricular wall (layer 1: subendocardium; layer 4: subepicardium). In group 1, % delta WT decreased 44 +/- 10% and only layer 1 MBF was significantly reduced (-28%); in group 2, % delta WT decreased 77 +/- 8% and MBF was reduced in both layers 1 and 2 (-52% and -36%, respectively); in group 3, % delta WT decreased 104 +/- 3% and MBF was reduced in the three inner layers (layer 1: -65%; layer 2: -58%; layer 3: -34%); in group 4, % delta WT decreased 145 +/- 9% (systolic wall thinning) and transmural reduction of MBF was found (layer 1: -74%; layer 2: -68%; layer 3: -55%; layer 4: -29%). We conclude that (1) up to 75% reduction in systolic wall thickening may occur when perfusion to only the inner one-half of the myocardium is decreased; (2) akinetic wall motion may be observed when perfusion remains normal in the subepicardial one-fourth of the wall; and (3) dyskinesia (wall thinning) occurs when blood flow is reduced transmurally.
在15只开胸麻醉犬中，在用水力封堵器造成不同程度的冠状动脉狭窄之前和之后，用超声心动图测量局部收缩期室壁增厚（%ΔWT），并用示踪微球（7 - 10微米）测定局部血流。根据对%ΔWT的影响，将狭窄分为四组，并测定心室壁四层（第1层：心内膜下；第4层：心外膜下）相应的心肌血流量（MBF）。在第1组中，%ΔWT下降44±10%，仅第1层MBF显著降低（-28%）；在第2组中，%ΔWT下降77±8%，第1层和第2层MBF均降低（分别为-52%和-36%）；在第3组中，%ΔWT下降104±3%，三层内层（第1层：-65%；第2层：-58%；第3层：-34%）MBF降低；在第4组中，%ΔWT下降145±9%（收缩期室壁变薄），发现MBF呈透壁性降低（第1层：-74%；第2层：-68%；第3层：-55%；第4层：-29%）。我们得出结论：（1）当仅心肌内层一半的灌注减少时，收缩期室壁增厚可能减少达75%；（2）当室壁心外膜下四分之一的灌注保持正常时，可能观察到运动不能性室壁运动；（3）当血流呈透壁性减少时，会出现运动障碍（室壁变薄）。
