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冠状动脉闭塞后犬和狒狒的冠状动脉侧支循环比较。

Comparison of the coronary collateral circulation in dogs and baboons after coronary occlusion.

作者信息

Weisse A B, Kearney K, Narang R M, Regan T J

出版信息

Am Heart J. 1976 Aug;92(2):193-200. doi: 10.1016/s0002-8703(76)80254-2.

Abstract

The relevance to man of experimental observations on coronary collateral blood flow (CCBF) in dogs has been questioned. The effect of 2 to 3 hour coronary occlusions in the anesthetized dog and a primate, the baboon, were therefore compared, with CCBF measured by injections of 85Kr distal to occlusion with precordial counting. Before killing, additional isotope was infused to compare inner/outer wall flow distribution and myocardial tissue samples were analyzed for electrolyte content. Effects of nitrates on hemodynamics and metabolism were also compared in dog and baboon. Similar values for CCBF and resistance following occlusions were found in dog and baboon (flow approximately 25 per cent control, calculated resistance increase four- to sevenfold). Greater subendocardial ischemia in both species was indicated by isotope distribution less to the inner wall, but electrolyte changes (k+ less and Na+ greater in the ischemic area compared to nonischemic) were similar transmurally in both species. Hemodynamic responses to nitrate infusion (isosorbide dinitrate) were similar, with increase in CCBF and decrease in resistance. In neither group were inner/outer wall isotope distribution or electrolyte changes influenced by nitrate. The coronary collateral response to occlusion is similar in dog and baboon in terms of both hemodynamics and metabolic changes. After 2 to 3 hours of coronary occlusion some hemodynamic benefit may be demonstrated with nitrates but no metabolic advantage, at least in the central area of ischemia.

摘要

犬冠状动脉侧支血流(CCBF)的实验观察结果与人类的相关性一直受到质疑。因此,比较了麻醉犬和灵长类动物狒狒2至3小时冠状动脉闭塞的影响,通过在闭塞远端注射85Kr并进行心前区计数来测量CCBF。处死前,注入额外的同位素以比较内膜/外膜血流分布,并分析心肌组织样本的电解质含量。还比较了硝酸盐对犬和狒狒血流动力学和代谢的影响。犬和狒狒在闭塞后CCBF和阻力的数值相似(血流约为对照值的25%,计算得出的阻力增加4至7倍)。两种动物内膜下缺血更严重,表现为同位素向内膜的分布减少,但两种动物跨壁的电解质变化相似(与非缺血区域相比,缺血区域钾离子减少,钠离子增加)。对硝酸盐输注(二硝酸异山梨酯)的血流动力学反应相似,CCBF增加,阻力降低。两组内膜/外膜同位素分布或电解质变化均未受硝酸盐影响。就血流动力学和代谢变化而言,犬和狒狒对冠状动脉闭塞的侧支反应相似。冠状动脉闭塞2至3小时后,硝酸盐可能会带来一些血流动力学益处,但至少在缺血中心区域没有代谢优势。

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