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实验性心肌梗死后晚期再灌注后卡托普利治疗对左心室重构的影响。

Effects of captopril therapy after late reperfusion on left ventricular remodeling after experimental myocardial infarction.

作者信息

Jain P, Korlipara G, Mallavarapu C, Sikand V, Lillis O, Cohn P F

机构信息

Department of Medicine, State University of New York, Stony Brook 11794-8171.

出版信息

Am Heart J. 1994 Apr;127(4 Pt 1):756-63. doi: 10.1016/0002-8703(94)90541-x.

Abstract

Reperfusion that is too late to salvage ischemic myocardium reduces early infarct expansion, and captopril therapy favorably alters long-term left ventricular remodeling. To study whether the beneficial effects of these two therapies are additive, we examined the effects of captopril therapy after late reperfusion on left ventricular remodeling after acute myocardial infarction. Female Sprague-Dawley rats (n = 67) were randomly assigned to one of four groups: group 1, sham surgery and no treatment; group 2, left coronary artery ligation and no treatment (myocardial infarction [r MI]); group 3, left coronary artery ligation, reperfusion 2 hours later, and no treatment (late reperfusion [LR]); and group 4, left coronary artery ligation, reperfusion 2 hours later, and captopril treatment (LR-Cap). Captopril therapy (2 gm/L of drinking water) was begun in the LR-Cap group in the immediate post-operative period and continued for 20 days. Twenty-one days postoperatively, hemodynamic measurements were made before and after volume loading. The rats were killed, their hearts were removed, and passive pressure-volume curves were obtained. The hearts were then fixed at a constant pressure for morphometric analysis. Compared with the MI group, the LR group had a lower expansion index and a higher thinning ratio. There were no differences in hemodynamics, left ventricular volumes, or other morphometric indexes between the two groups. Compared with the MI and LR groups, the LR-Cap group had lower peak left ventricular end-diastolic pressure, lower left ventricular volume, lower left and right ventricular weights, and a leftward shift of pressure-volume curves.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

再灌注时机过晚无法挽救缺血心肌时,可减少早期梗死扩展,而卡托普利治疗能有利地改变长期左心室重构。为研究这两种治疗的有益效果是否具有叠加性,我们检测了急性心肌梗死后晚期再灌注后卡托普利治疗对左心室重构的影响。将雌性Sprague-Dawley大鼠(n = 67)随机分为四组:第1组,假手术且未治疗;第2组,左冠状动脉结扎且未治疗(心肌梗死[r MI]);第3组,左冠状动脉结扎,2小时后再灌注,且未治疗(晚期再灌注[LR]);第4组,左冠状动脉结扎,2小时后再灌注,且进行卡托普利治疗(LR-Cap)。LR-Cap组在术后即刻开始给予卡托普利治疗(2 g/L饮用水),持续20天。术后21天,在容量负荷前后进行血流动力学测量。处死大鼠,取出心脏,获得被动压力-容积曲线。然后将心脏固定在恒定压力下进行形态计量分析。与MI组相比,LR组的扩展指数较低,变薄率较高。两组之间的血流动力学、左心室容积或其他形态计量指标无差异。与MI组和LR组相比,LR-Cap组的左心室舒张末期压力峰值较低、左心室容积较低、左、右心室重量较低,且压力-容积曲线向左移位。(摘要截短于250字)

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