Lazzara R R, Park S E, Cmolik B L, Trumble D R, Magovern J A
Department of Surgery, Allegheny General Hospital, Pittsburgh, PA 15212.
J Heart Lung Transplant. 1993 Nov-Dec;12(6 Pt 1):1024-8.
When the latissimus dorsi is used for ventricular augmentation in cardiomyoplasty, a delay of several weeks occurs before the muscle revascularizes, adheres to the heart, and is transformed to fatigue-resistant status. This study analyzes the effect of static (unstimulated) cardiomyoplasty on left ventricular function. Four mongrel dogs underwent staged left latissimus dorsi cardiomyoplasty. Left ventricular pressure was measured with a micromanometer catheter. Left ventricular volume was measured by sonomicrometry. Cardiac output, heart rate, preload recruitable stroke work, maximum elastance, left ventricular end-diastolic volume, left ventricular end-diastolic pressure, stroke work, and the diastolic relaxation constant were measured before and immediately after cardiomyoplasty with the myoplasty static. Results, expressed as mean +/- standard error of the mean, showed no significant differences in indexes of systolic function (stroke work, 1017 +/- 223 gm.cm to 984 +/- 403 gm.cm; preload recruitable stroke work, 110 +/- 13 gm.cm/cm3 to 115 +/- 19.8 gm.cm/cm3; maximum elastance, 10.38 +/- 5.6 mm Hg/ml to 13.59 +/- 6.5 mm Hg/ml; cardiac output 4.51 +/- 0.43 L/min to 4.21 +/- 0.34 L/min) or diastolic function (left ventricular end-diastolic volume, 21 +/- 5.2 ml to 20 +/- 5.3 ml; left ventricular end-diastolic pressure, 13 +/- 3.5 mm Hg to 15 +/- 3 mm Hg; diastolic relaxation constant 42.8 +/- 5.2 msec to 42.5 +/- 4.5 msec). Heart rate also remained unchanged (131 +/- 8.9 beats/min to 140 +/- 9.8 beats/min). The static (unstimulated) left latissimus dorsi cardioplasty can be done with little effect on left ventricular systolic or diastolic function in the normal canine heart.
当在心肌成形术中使用背阔肌进行心室增强时,在肌肉重新血管化、附着于心脏并转变为抗疲劳状态之前会有几周的延迟。本研究分析了静态(未刺激)心肌成形术对左心室功能的影响。对四只杂种犬进行了分期左背阔肌心肌成形术。用微测压导管测量左心室压力。通过超声心动图测量左心室容积。在心肌成形术之前和之后立即测量心输出量、心率、可预负荷性搏功、最大弹性、左心室舒张末期容积、左心室舒张末期压力、搏功和舒张期松弛常数。结果以平均值±平均标准误差表示,收缩功能指标(搏功,1017±223克·厘米至984±403克·厘米;可预负荷性搏功,110±13克·厘米/立方厘米至115±19.8克·厘米/立方厘米;最大弹性,10.38±5.6毫米汞柱/毫升至13.59±6.5毫米汞柱/毫升;心输出量4.51±0.43升/分钟至4.21±0.34升/分钟)或舒张功能指标(左心室舒张末期容积,21±5.2毫升至20±5.3毫升;左心室舒张末期压力,13±3.5毫米汞柱至15±3毫米汞柱;舒张期松弛常数42.8±5.2毫秒至42.5±4.5毫秒)无显著差异。心率也保持不变(131±8.9次/分钟至140±9.8次/分钟)。在正常犬心脏中,静态(未刺激)左背阔肌心肌成形术对左心室收缩或舒张功能影响很小。