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慢性部分冠状动脉狭窄解除后猪心脏的心肌功能与代谢

Myocardial function and metabolism in pig hearts after relief from chronic partial coronary stenosis.

作者信息

Liedtke A J, Renstrom B, Nellis S H, Subramanian R

机构信息

Cardiology Section, University of Wisconsin Hospital and Clinics, Madison 53792-3248.

出版信息

Am J Physiol. 1994 Oct;267(4 Pt 2):H1312-9. doi: 10.1152/ajpheart.1994.267.4.H1312.

Abstract

Metabolic behavior was compared during acute extracorporeal reperfusion after removal of a chronic 4-day partial coronary stenosis in eight pig hearts (RCS group) and during comparable extracorporeal perfusion in seven chronically prepared hearts (Sham group). Coronary stenosis in RCS hearts was induced in the left anterior descending (LAD) artery by partial inflation of a hydraulic occluder to restrict LAD peak phasic velocity by approximately 50%. Regional mechanical shortening was decreased in RCS compared with Sham hearts after 4 days of chronic coronary stenosis [diminished systolic shortening (P < 0.066) with systolic expansion (P < 0.015)] but was comparable to Sham hearts after relief from stenosis. At analogous workloads (left ventricular pressure and heart rate) during reperfusion, metabolic behavior was distinctive between groups. Specifically, compared with Sham hearts, myocardial O2 consumption was selectively increased in RCS hearts (+ 49 delta %, P < 0.026) as was fatty acid oxidation estimated from 14CO2 production from [U-14C]palmitate (+ 60 delta %, P < 0.061) and exogenous glucose utilization measured from the release of 3H2O from [5-3H]glucose (+ 517 delta %, P < 0.025). At the conclusion of the studies, triphenyltetrazolium chloride staining showed no gross evidence of macroinfarction in RCS or Sham hearts, and there was an essentially unremarkable histological survey of anterior myocardium for microscopic necrosis in either group. The level of O2 consumption and preservation of preferred fatty acid utilization indicate that metabolism remains or regains its aerobic pattern of activity in early recovery immediately after removal of chronic partial coronary stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在八只猪心脏去除慢性4天部分冠状动脉狭窄后的急性体外再灌注期间(RCS组),以及在七只慢性制备心脏的类似体外灌注期间(假手术组),对代谢行为进行了比较。通过液压封堵器部分充气在左前降支(LAD)动脉中诱导RCS心脏的冠状动脉狭窄,以将LAD峰值相速度限制约50%。与假手术心脏相比,慢性冠状动脉狭窄4天后RCS心脏的局部机械缩短减少[收缩期缩短减少(P<0.066),收缩期扩张(P<0.015)],但在狭窄解除后与假手术心脏相当。在再灌注期间类似的工作负荷(左心室压力和心率)下,两组之间的代谢行为不同。具体而言,与假手术心脏相比,RCS心脏的心肌氧消耗选择性增加(+49δ%,P<0.026),从[U-14C]棕榈酸酯的14CO2产生估计的脂肪酸氧化也增加(+60δ%,P<0.061),以及从[5-3H]葡萄糖释放的3H2O测量的外源性葡萄糖利用增加(+517δ%,P<0.025)。在研究结束时,氯化三苯基四氮唑染色显示RCS或假手术心脏均无明显的大面积梗死证据,并且两组前壁心肌的微观坏死组织学检查基本无异常。氧消耗水平和首选脂肪酸利用的保留表明,在去除慢性部分冠状动脉狭窄后早期恢复中,代谢仍保持或恢复其有氧活动模式。(摘要截断于250字)

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