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冠状静脉逆向灌注和血管扩张对微球测量局部心肌血流量的影响。对缺血再灌注猪心脏“微球丢失”的分析。

Influence of coronary venous retroinfusion and vasodilatation on regional myocardial blood flow measurement with microspheres. An analysis of 'microsphere loss' from ischaemic and reperfused porcine hearts.

作者信息

Haga Y, Nordlander R, Sjöquist P O, Rydén L

机构信息

Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.

出版信息

Acta Physiol Scand. 1995 Jan;153(1):13-20. doi: 10.1111/j.1748-1716.1995.tb09829.x.

Abstract

The influence of coronary venous retroinfusion and a vasoselective calcium antagonist felodipine on the microsphere loss in a porcine model of myocardial ischaemia and reperfusion was studied. Sixteen open-chest pigs underwent 45 min of myocardial ischaemia induced by occlusion of the left anterior descending coronary artery followed by 4 h of reperfusion. Either felodipine (felo-retro group, 7 nmol kg-1, n = 6) or the corresponding amount of vehicle (vehicle-retro group, n = 5) was infused retrogradely into the coronary veins over 30 min, starting 5 min before reperfusion. In a third group, the same amount of felodipine was administered intravenously (felo-iv group, n = 5). Myocardial regional blood flow was measured with radiolabelled microspheres (phi = 15 microns) injected before ischaemia to investigate a possible loss during ischaemia. In the felo-retro group, the apparent blood flow in the ischaemic areas, expressed as a percentage of the corresponding values in the non-ischaemic areas (%-flow), were 73 +/- 15, 73 +/- 11 and 75 +/- 19 in the subendocardial, midmyocardial and subepicardial layers, respectively. The corresponding percentage flows were 64 +/- 11, 70 +/- 11 and 62 +/- 9 in the vehicle-retro group and 75 +/- 18, 77 +/- 15 and 76 +/- 11 in the felo-iv group. The differences between the groups were not statistically significant. It is concluded that in this open-chest preparation microsphere loss observed in the ischaemic and reperfused myocardium is not increased by coronary venous retroinfusion or by a concomitantly administered vasodilative agent like felodipine.

摘要

研究了冠状动脉逆行灌注和血管选择性钙拮抗剂非洛地平对猪心肌缺血再灌注模型中微球丢失的影响。16只开胸猪接受了45分钟的左前降支冠状动脉闭塞诱导的心肌缺血,随后进行4小时的再灌注。在再灌注前5分钟开始,将非洛地平(非洛地平逆行灌注组,7 nmol/kg,n = 6)或相应量的赋形剂(赋形剂逆行灌注组,n = 5)在30分钟内逆行注入冠状静脉。在第三组中,静脉注射相同量的非洛地平(非洛地平静脉注射组,n = 5)。在缺血前注射放射性标记的微球(直径 = 15微米)测量心肌局部血流量,以研究缺血期间可能的丢失情况。在非洛地平逆行灌注组中,缺血区域的表观血流量,以非缺血区域相应值的百分比表示(%-血流量),在心内膜下层、心肌中层和心外膜下层分别为73±15、73±11和75±19。赋形剂逆行灌注组相应的百分比血流量分别为64±11、70±11和62±9,非洛地平静脉注射组为75±18、77±15和76±11。各组之间的差异无统计学意义。结论是,在这种开胸准备中,冠状动脉逆行灌注或同时给予非洛地平这样的血管扩张剂不会增加缺血和再灌注心肌中观察到的微球丢失。

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