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[新型经肺造影剂冠状动脉内注射的伴随血流动力学效应]

[Concomitant hemodynamic effects of intracoronary injections of a new transpulmonary contrast medium].

作者信息

Schröder T, Hering J P, Hellige G

机构信息

Zentrum Anästhesiologie, Rettungs-und Intensivmedizin, Abteilung Anästhesiologische Forschung, Universität Göttingen.

出版信息

Ultraschall Med. 1995 Apr;16(2):70-2. doi: 10.1055/s-2007-1003990.

Abstract

AIM

A new transpulmonary echo contrast agent (SH U 508) was injected intracoronally to six anaesthetised sheep to examine its possible direct cardiac effects.

METHOD

SH U 508 was injected in randomised order in three different volumes (2, 4 and 8 ml; n = 12, 10, 9) with the same drug concentration of 200 mg/ml.

RESULTS

The 2 ml and 4 ml injections had no relevant effect on the arterial, pulmonary-arterial and ventricular pressures, on the left ventricular contraction velocity and on the myocardial blood flow (less than +/- 10% of the control value). The left ventricular relaxation velocity decreased by 20%. The disturbance of the left ventricular relaxation at a volume of 8 ml was pronounced (about 40% decrease). Slight left ventricular dysfunction further manifested itself in a decreased systolic pressure (-15%) and increased left ventricular enddiastolic pressure (20%).

CONCLUSION

In summary the overall effect of the intracoronary injections of SH U 508 exhibited only minor cardiac side effects. If the current results are extrapolated to peripheral-venous application, the clinically required central-venous 8 ml injection of a 400 mg/ml suspension is not expected to produce any coronary haemodynamic side effects, due to drug dilution in the pulmonary circulation and resulting low intra-coronary concentrations.

摘要

目的

将一种新型经肺超声造影剂(SH U 508)冠状动脉内注射到六只麻醉的绵羊体内,以检查其可能的直接心脏效应。

方法

以随机顺序注射三种不同体积(2、4和8毫升;n分别为12、10、9)、药物浓度均为200毫克/毫升的SH U 508。

结果

2毫升和4毫升的注射对动脉压、肺动脉压和心室压、左心室收缩速度及心肌血流均无显著影响(变化小于对照值的±10%)。左心室舒张速度下降了20%。8毫升体积时左心室舒张的干扰较为明显(下降约40%)。轻微的左心室功能障碍进一步表现为收缩压降低(-15%)和左心室舒张末期压力升高(20%)。

结论

总之,冠状动脉内注射SH U 508的总体效应仅表现出轻微的心脏副作用。如果将目前的结果外推至外周静脉应用,由于药物在肺循环中的稀释以及由此导致的冠状动脉内低浓度,临床上所需的400毫克/毫升悬浮液8毫升中心静脉注射预计不会产生任何冠状动脉血流动力学副作用。

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