Rubboli A, Sobotka P A, Euler D E
Department of Medicine, Loyola University Medical Center, Maywood, Illinois 60153.
Am J Physiol. 1994 Sep;267(3 Pt 2):H1054-61. doi: 10.1152/ajpheart.1994.267.3.H1054.
The impact of acute myocardial edema on coronary flow and left ventricular performance was studied in isolated isovolumic rat hearts. After 15 min of aortic perfusion with Krebs-Henseleit buffer, hearts (10/group) were either removed for determination of water content or perfused for another 90 min. Three groups were perfused at a constant pressure of 60, 100, or 140 mmHg, and two groups were perfused at 60 or 140 mmHg with adenosine added. Compared with the 15-min group, there was a significant increase in water content in all groups except the 60-mmHg group (P < 0.005). There was a direct linear relationship between increases in coronary vascular resistance over time and water content (P < 0.0001). A decrease in developed pressure and peak +dP/dt was observed only in those groups that accumulated water. An inverse linear relationship was found between changes in developed pressure and water content (P = 0.0001). Water content had no effect on end-diastolic pressure below 5 ml/g; above 5 ml/g, a direct linear relationship was evident (P = 0.009). The results suggest that myocardial edema increases vascular resistance and decreases systolic performance. End-diastolic pressure is less influenced by edema than either systolic or coronary vascular function.
在离体等容大鼠心脏中研究了急性心肌水肿对冠状动脉血流和左心室功能的影响。用克雷布斯-亨塞尔特缓冲液对主动脉灌注15分钟后，将心脏（每组10个）取出用于测定含水量，或再灌注90分钟。三组分别在60、100或140 mmHg的恒定压力下进行灌注，两组在60或140 mmHg的压力下添加腺苷进行灌注。与15分钟组相比，除60 mmHg组外，所有组的含水量均显著增加（P < 0.005）。冠状动脉血管阻力随时间的增加与含水量之间存在直接线性关系（P < 0.0001）。仅在那些积水的组中观察到舒张末压力和峰值 +dP/dt 降低。舒张末压力变化与含水量之间存在反向线性关系（P = 0.0001）。含水量在低于5 ml/g时对舒张末压力无影响；高于5 ml/g时，呈直接线性关系（P = 0.009）。结果表明，心肌水肿会增加血管阻力并降低收缩功能。水肿对舒张末压力的影响小于对收缩功能或冠状动脉血管功能的影响。
