Sidi A, Rush W
Department of Anesthesiology, University of Florida College of Medicine, Gainesville 32610-0254, USA.
J Cardiothorac Vasc Anesth. 1996 Apr;10(3):368-73. doi: 10.1016/s1053-0770(96)80099-1.
To compare measurements of regional myocardial blood flow between color and radioactive microspheres.
Prospective, randomized, controlled.
University research laboratory.
Pigs.
Pigs underwent constriction of the left anterior descending artery, either incremental and then 0 constriction with epinephrine, 0.5 to 3 mu/kg/min (n = 5; "variable") or only 0% and 100% constriction without epinephrine (n = 4, "single"). Radioactive and color microspheres were injected simultaneously. For variable constriction, 5 colors (3 x 10(6)/mL) were tested in random order and, for single, red and yellow (6 x 10(6)/2 mL).
Measurements of regional endocardial, epicardial, and transmural myocardial blood flow were compared by regression analysis (linear and nonlinear). With radioactive measurements as the point of reference, when regional flow was 50 to 150 mL/min/100 g, correlation was high (r = 0.85), although regression slope was low. With endocardial and epicardial flow between 30 and 100 mL/min/100 g, correlation was close (r = 0.84). Overall nonlinear correlation was higher with single than variable constriction (r = 0.72). When regional flow was less than 100 mL/min/100 g, linear correlation was r = 0.72. When transmural flow measured by color microspheres was less than 25 mL/min/100 g, correlation was high (r = 0.86) but, with endocardial or epicardial flow, low (r = 0.67). When transmural flow was greater than 100 mL/min/100 g, correlation was extremely low (r = 0.1; n = 26 data points). The overall correlations for regional endocardial and epicardial flows were also low, except in the ischemic zone.
Color and radioactive measurements correlate well during moderate and ischemic regional myocardial blood flow, ischemic blood flow requiring a higher concentration of color microspheres. A major limitation of using color microspheres is imprecision when flow is greater than 150 mL/min 100 g.
比较彩色微球与放射性微球对局部心肌血流量的测量结果。
前瞻性、随机、对照研究。
大学研究实验室。
猪。
猪接受左前降支缩窄，一组先递增缩窄，然后用肾上腺素以0.5至3微克/千克/分钟的剂量进行0缩窄（n = 5；“可变组”），另一组仅进行0%和100%缩窄且不用肾上腺素（n = 4，“单一组”）。同时注射放射性微球和彩色微球。对于可变缩窄组，随机测试5种颜色的微球（3×10⁶/毫升），对于单一组，测试红色和黄色微球（6×10⁶/2毫升）。
通过回归分析（线性和非线性）比较局部心内膜、心外膜和透壁心肌血流量的测量结果。以放射性测量结果为参考，当局部血流量为50至150毫升/分钟/100克时，相关性较高（r = 0.85），尽管回归斜率较低。当心内膜和心外膜血流量在30至100毫升/分钟/100克之间时，相关性密切（r = 0.84）。单一缩窄组的总体非线性相关性高于可变缩窄组（r = 0.72）。当局部血流量小于100毫升/分钟/100克时，线性相关性为r = 0.72。当彩色微球测量的透壁血流量小于25毫升/分钟/100克时，相关性较高（r = 0.86），但对于心内膜或心外膜血流量，相关性较低（r = 0.67）。当透壁血流量大于100毫升/分钟/100克时，相关性极低（r = 0.1；n = 26个数据点）。除缺血区外，局部心内膜和心外膜血流量的总体相关性也较低。
在中度和缺血性局部心肌血流量测量中，彩色微球与放射性微球测量结果相关性良好，缺血血流量需要更高浓度的彩色微球。使用彩色微球的一个主要局限性是当血流量大于150毫升/分钟/100克时测量不准确。
