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顿抑心肌的舒张功能障碍

Diastolic dysfunction of stunned myocardium.

作者信息

Ehring T, Schulz R, Schipke J D, Heusch G

机构信息

Dept. of Pathophysiology, University of Essen Medical School, FRG.

出版信息

Am J Cardiovasc Pathol. 1993;4(4):358-66.

PMID:8305199
Abstract

The prolonged regional contractile failure of reperfused myocardium has usually been characterized in terms of systolic function, while only few reports on its diastolic function are available. None of these studies considered changes in the isovolumic diastole and the subsequent filling phase separately. Therefore, in the present study, the velocities of wall excursion during systole (Vsys), isovolumic diastole (Viso) and filling phase (Vfill) were determined in 12 anesthetized dogs. Additionally, post-ejection thickening (Pejt), a marker of left ventricular asynchrony, was determined. Measurements were performed under control conditions, during a 15 minute left circumflex (LCX) coronary artery occlusion (CAO) and at 10 minutes, 4 and 8 hours reperfusion. Heart rate, left ventricular pressure, and Vsys, Viso, Vfill, and Pejt of the anterior myocardium remained unchanged throughout the experiments. During CAO, systolic wall-thickening of the posterior wall was reversed to systolic wall-thinning. Upon reperfusion, Vsys started to recover (2.5 +/- 3.2 mm/s at 10 minutes) and gradually improved over 8 hours of reperfusion (4.6 +/- 3.2 mm/s at 4 hours, 6.4 +/- 1.5 mm/s at 8 hours). Viso became positive during CAO (9.4 +/- 7.1 mm/s vs. -5.6 +/- 3.9 mm/s under control conditions) and was unchanged at 10 minutes reperfusion (7.9 +/- 5.2 mm/s). After 4 hours and 8 hours of reperfusion, Viso recovered to 1.2 +/- 9.2 mm/s and -0.3 +/- 10.7 mm/s, respectively. Vfill also became positive during CAO (1.5 +/- 6.2 mm/s vs. -18 +/- 8.7 mm/s under control conditions). There was a quick recovery of Vfill (-9.4 +/- 7.5 mm/s) with the onset of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

再灌注心肌的长期局部收缩功能衰竭通常根据收缩功能来描述,而关于其舒张功能的报道却很少。这些研究均未分别考虑等容舒张期和随后的充盈期的变化。因此,在本研究中,测定了12只麻醉犬在收缩期(Vsys)、等容舒张期(Viso)和充盈期(Vfill)的室壁运动速度。此外,还测定了左心室不同步的标志物射血后增厚(Pejt)。在对照条件下、左旋支(LCX)冠状动脉闭塞(CAO)15分钟期间以及再灌注10分钟、4小时和8小时时进行测量。在整个实验过程中,心率、左心室压力以及前壁心肌的Vsys、Viso、Vfill和Pejt均保持不变。在CAO期间,后壁的收缩期心肌增厚转变为收缩期心肌变薄。再灌注时,Vsys开始恢复(10分钟时为2.5±3.2mm/s),并在8小时的再灌注过程中逐渐改善(4小时时为4.6±3.2mm/s,8小时时为6.4±1.5mm/s)。Viso在CAO期间变为正值(9.4±7.1mm/s,而对照条件下为-5.6±3.9mm/s),在再灌注10分钟时保持不变(7.9±5.2mm/s)。再灌注4小时和8小时后,Viso分别恢复到1.2±9.2mm/s和-0.3±10.7mm/s。Vfill在CAO期间也变为正值(1.5±6.2mm/s,而对照条件下为-18±8.7mm/s)。再灌注开始时,Vfill迅速恢复(-9.4±7.5mm/s)。(摘要截取自250字)

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