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犬急性低氧诱导型与机械诱导型肺动脉高压在血流动力学、心肌收缩力及局部血流方面的比较。

Comparison between acute hypoxia-induced and mechanically-induced pulmonary artery hypertension on the hemodynamics, myocardial contractility and regional blood flow in dogs.

作者信息

Girard C, Fargnoli J M, Fourie P, Maitrasse B, Arvieux C C

机构信息

Département d'Anesthésie Réanimation, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France.

出版信息

Fundam Clin Pharmacol. 1995;9(6):554-61. doi: 10.1111/j.1472-8206.1995.tb00533.x.

Abstract

Two groups of eight anesthetized dogs with pulmonary artery hypertension (PAH) were compared. PAH was induced by submitting one group (HP) to hypoxia (FiO2 range: 6-10%) and the other group (ME) to microemboli through glass microbead injection into the pulmonary circulation. Hypoxia-induced PAH was moderate (PAP: +65%; PVR: +152%) contrasting with marked PAH after microbead injection (PAP: +190%; PVR: +389%). For similar effects on left ventricular contractility (LV dP/dt max and segmental myocardial shortening), heart rate and systemic vascular resistance, left ventricular end-diastolic pressure showed significant differences between the two groups (HP group: +75%, ME group: -9%), and so did left ventricular end-diastolic length (HP: +9%, ME: -11%). Thus, contrary to the injection of microbeads, hypoxia did not give rise to any pulmonary barrier, and consequently the changes in cardiac output (HP: +19%, ME: -15%) and hepatic blood flow (HP: +383%, ME: -77%) were significantly different. Hypoxia, and not microbead injection, was responsible for systemic hypertension (MAP: +34% and -4%, respectively). The microbead model resulted in a significantly higher PVR/SVR ratio compared to the hypoxic model (HP: 0.14, ME: 0.41). Hypoxia increased left and right myocardial blood flows whereas microbead injection affected only right ventricular blood flow, leading to significantly different RV/LV endocardial perfusion ratios (HP: +10%, ME: +98%). We conclude that microbead-induced PAH is more appropriate than hypoxia-induced PAH for hemodynamic and pharmacological studies.

摘要

对两组各八只患有肺动脉高压(PAH)的麻醉犬进行了比较。通过使一组(HP组)处于低氧环境(吸入氧分数范围:6 - 10%)诱导PAH,另一组(ME组)通过向肺循环注射玻璃微珠形成微栓塞诱导PAH。低氧诱导的PAH程度为中度(肺动脉压:升高65%;肺血管阻力:升高152%),与注射微珠后明显的PAH(肺动脉压:升高190%;肺血管阻力:升高389%)形成对比。在对左心室收缩力(左心室dp/dt最大值和节段性心肌缩短)、心率和体循环血管阻力有相似影响的情况下,两组之间左心室舒张末期压力存在显著差异(HP组:升高75%,ME组:降低9%),左心室舒张末期长度也是如此(HP组:升高9%,ME组:降低11%)。因此,与注射微珠不同,低氧不会导致任何肺屏障形成,结果心输出量(HP组:升高19%,ME组:降低15%)和肝血流量(HP组:升高383%,ME组:降低77%)的变化有显著差异。导致系统性高血压的是低氧,而非注射微珠(平均动脉压分别升高34%和降低4%)。与低氧模型相比,微珠模型导致的肺血管阻力/体循环血管阻力比值显著更高(HP组:0.14,ME组:0.41)。低氧增加了左、右心肌血流量,而注射微珠仅影响右心室血流量,导致右心室/左心室心内膜灌注比值有显著差异(HP组:升高10%,ME组:升高98%)。我们得出结论,对于血流动力学和药理学研究,微珠诱导的PAH比低氧诱导的PAH更合适。

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