Groeneveld A B, Visser F C
Department of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands.
Basic Res Cardiol. 1993 May-Jun;88(3):223-32. doi: 10.1007/BF00794995.
Blood flow heterogeneity in normal myocardium may be caused by heterogeneous metabolic demand. We studied, from 80 tissue samples of the left ventricle (LV) of eight anesthetised, open-chest dogs (with prior beta-blockade (metoprolol) in four dogs), the radioactivity of 201Thallium-chloride (201Tl), an indicator of blood flow, and of the fatty acid 131-Iodine-heptadecanoic acid (131I-HDA), an indicator of metabolic demand, 3 min after intravenous injection. Global LV uptake (in percent of injected dose x 10(-2), per g tissue; mean +/- SD) was 4.94 +/- 0.71 for 201Tl and 4.48 +/- 0.58 for 131I-HDA in the dogs without beta-blockade, and 2.08 +/- 0.26 and 1.69 +/- 0.20, respectively, in dogs with beta-blockade (p < 0.05). Beta-blockade thus decreased the fraction of cardiac output delivered to the LV, concurrently with a decreased heart rate and arterial blood pressure (p < 0.05) and, thus, global metabolic demand and fatty acid uptake. Regional radioactivities per gram were normalized for mean LV radioactivities and heterogeneity was expressed as the coefficient of variation (CV). For pooled data (n = 320) in dogs without beta-blockade, regional 201Tl and 131I-HDA radioactivities varied from a factor of 0.1 to 1.6 and 0.3 to 1.8 of mean radioactivities, with a CV of 22.9 and 19.4%, respectively, and correlated (r = 0.77, p < 0.005). For pooled data (n = 320) in dogs with beta-blockade, regional 201Tl and 131I-HDA radioactivities varied from a factor of 0.2 to 1.5 and 0.2 to 1.6 of mean radioactivity and CV was 23.6% and 24.8%, respectively; r = 0.92 (p < 0.005). The endo/epi ratio for both radioactivities exceeded unity in each dog. In normal myocardium, blood flow and fatty acid uptake are thus heterogeneous, both transmurally and circumferentially, and matched, concomitantly with coupling of global blood flow to global metabolic demand and fatty acid uptake. This supports the idea that heterogeneous myocardial O2 supply reflects heterogeneous metabolic demand.
正常心肌中的血流异质性可能由代谢需求不均一引起。我们对8只麻醉开胸犬左心室(LV)的80个组织样本进行了研究(其中4只犬事先给予了β受体阻滞剂(美托洛尔)),在静脉注射后3分钟,检测了作为血流指标的氯化亚铊(201Tl)和作为代谢需求指标的脂肪酸131碘十七烷酸(131I-HDA)的放射性。未给予β受体阻滞剂的犬中,LV整体摄取量(每克组织中注射剂量的百分比×10(-2);均值±标准差),201Tl为4.94±0.71,131I-HDA为4.48±0.58;给予β受体阻滞剂的犬中,相应数值分别为2.08±0.26和1.69±0.20(p<0.05)。因此,β受体阻滞剂降低了输送至LV的心输出量比例,同时心率和动脉血压下降(p<0.05),进而整体代谢需求和脂肪酸摄取减少。每克组织的区域放射性以LV平均放射性进行标准化,异质性以变异系数(CV)表示。对于未给予β受体阻滞剂犬的汇总数据(n = 320),区域201Tl和131I-HDA放射性分别为平均放射性的0.1至1.6倍和0.3至1.8倍,CV分别为22.9%和19.4%,且两者相关(r = 0.77,p<0.005)。对于给予β受体阻滞剂犬的汇总数据(n = 320),区域201Tl和131I-HDA放射性分别为平均放射性的0.2至1.5倍和0.2至1.6倍,CV分别为23.6%和24.8%;r = 0.92(p<0.005)。每只犬两种放射性的内膜/外膜比值均超过1。因此,在正常心肌中,血流和脂肪酸摄取在透壁和周向均存在异质性,且相互匹配,同时整体血流与整体代谢需求及脂肪酸摄取相耦联。这支持了心肌氧供应不均一反映代谢需求不均一这一观点。