Hagendorff A, Dettmers C, Block A, Pizzulli L, Omran H, Hartmann A, Manz M, Lüderitz B
Department of Cardiology, University of Bonn, Germany.
Eur Heart J. 1994 Nov;15(11):1477-81. doi: 10.1093/oxfordjournals.eurheartj.a060417.
A reduction of cerebral blood flow (CBF) was observed in experimental studies in rats immediately after the onset of parasystolic rhythm or with stable, but haemodynamically compromising, tachycardias. Based on these data and with a view to studying the effects of premature ventricular contractions (PVCs) on the cerebral circulation in humans, CBF was measured using the 133-Xenon inhalation method in 24 age matched human controls (group A1: age 58.5 +/- 6.2 years; group A2: 52.2 +/- 7.8 years) in nine coronary artery disease (CAD) patients without PVCs (B), in 11 CAD patients with frequent PVCs (> 300.h-1) (C) and in nine patients, after exclusion of CAD by angiography, also with frequent PVCs (> 300.h-1) (D). Holter monitoring was performed during the CBF measurement. CBF determined in the human control groups A1 and A2 was 79.9 +/- 9.9 ml.100 g.-1 min-1 and 81.5-13.0 ml. 100 g-1 min-1, respectively. CBF was 74.1 +/- 13.6 ml . 100 g.-1 min-1 (P = 0.267 vs A1) in group B, 65.8 +/- 11.8 ml.100 g-1 min-1 (P = 0.004 vs A1) in group C and 74.2 +/- 15.6 ml.100 g.-1 min-1 (P = 0.218 vs A2) in group D. The significant reduction of CBF in CAD patients with frequent PVCs suggests that arrhythmias have a significant impact on CBF. Non-CAD patients with frequent PVCs did not show significant CBF decreases in comparison with controls. One can hypothetize that an impairment of electrical postextrasystolic potentiation, due to premature ventricular depolarization, and hence myocardial dysfunction leads to CBF reduction in CAD patients. The CBF reduction with CAD could also reflect concomitant coronary and cerebral arteriosclerosis.
在大鼠实验研究中观察到，在并行收缩期节律开始后即刻或出现稳定但血流动力学受损的心动过速时，脑血流量（CBF）会降低。基于这些数据，并为了研究室性早搏（PVCs）对人体脑循环的影响，采用133 - 氙吸入法对24名年龄匹配的健康对照者（A1组：年龄58.5±6.2岁；A2组：52.2±7.8岁）、9名无PVCs的冠心病（CAD）患者（B组）、11名频发PVCs（>300次/小时）的CAD患者（C组）以及9名经血管造影排除CAD但同样频发PVCs（>300次/小时）的患者（D组）测量了CBF。在测量CBF期间进行了动态心电图监测。A1组和A2组健康对照者测定的CBF分别为79.9±9.9 ml·100 g⁻¹·min⁻¹和81.5 - 13.0 ml·100 g⁻¹·min⁻¹。B组的CBF为74.1±13.6 ml·100 g⁻¹·min⁻¹（与A1组相比，P = 0.267），C组为65.8±11.8 ml·100 g⁻¹·min⁻¹（与A1组相比，P = 0.004），D组为74.2±15.6 ml·100 g⁻¹·min⁻¹（与A2组相比，P = 0.218）。频发PVCs的CAD患者CBF显著降低，提示心律失常对CBF有显著影响。与对照组相比，频发PVCs的非CAD患者CBF未显示出显著下降。可以推测，由于室性早搏去极化导致的期外收缩后电增强受损，进而心肌功能障碍，导致CAD患者CBF降低。CAD患者CBF降低也可能反映了冠状动脉和脑动脉粥样硬化并存。
