Shen Y T, Fallon J T, Iwase M, Vatner S F
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Am J Physiol. 1996 May;270(5 Pt 2):H1812-8. doi: 10.1152/ajpheart.1996.270.5.H1812.
To determine whether the extent of myocardial infarction differs in conscious baboons and pigs, both devoid of performed collaterals, the effects of 40 and 90 min of coronary artery (CA) occlusion (O) both followed by 4-7 days of CA reperfusion (R) were examined in both species. CAO reduced subendocardial and subepicardial blood flows similarly, almost to zero, in baboons and pigs for the entire CAO period. At 24 h of CAR, subendocardial blood flow had almost returned to pre-CAO control levels in baboons but remained significantly depressed in pigs. The major difference in hemodynamics during CAO and CAR was in left ventricular end-diastolic pressure, which rose by 6 +/- 1 mmHg in pigs over the initial 24-h reperfusion period but did not change significantly in baboons. These data on recovery of subendocardial blood flow and left ventricular end-diastolic pressure suggest larger infarcts in pigs than in baboons. Indeed, infarct size expressed as a function of area at risk (IF/AAR) was significantly greater (P < 0.05) in pigs (53 +/- 4.9%) than in baboons (17 +/- 2.9%) with 90 min of CAO and 4-7 days of CAR. With 40 min of CAO and 4-7 days of CAR, IF/AAR was 46 +/- 3.6% in pigs, whereas in baboons the IF/AAR was minimal, i.e., 2 +/- 0.6%. Thus pigs and baboons were characterized by minimal coronary collateral circulation, but infarct size was significantly less in conscious baboons than in conscious pigs. Potentially, these differences could be explained, in part, by natural protective mechanisms and/or less reperfusion injury in primates. These results in primates may also help explain the salutary effects of CAR in patients at intervals longer than have been demonstrated to be beneficial in other experimental animals.
为了确定在没有预先形成侧支循环的清醒狒狒和猪中,心肌梗死的范围是否不同,我们研究了冠状动脉(CA)闭塞(O)40分钟和90分钟后再灌注(R)4 - 7天对这两种动物的影响。在整个CAO期间,CAO使狒狒和猪的心内膜下和心外膜下血流同样减少,几乎降至零。在CAR 24小时时,狒狒的心内膜下血流几乎恢复到CAO前的对照水平,但猪的心内膜下血流仍显著降低。CAO和CAR期间血流动力学的主要差异在于左心室舒张末期压力,在最初的24小时再灌注期,猪的左心室舒张末期压力升高了6±1 mmHg,而狒狒的左心室舒张末期压力没有显著变化。这些关于心内膜下血流恢复和左心室舒张末期压力的数据表明,猪的梗死面积比狒狒大。实际上,在90分钟CAO和4 - 7天CAR后,以危险区域面积为函数表示的梗死面积(IF/AAR)在猪中(53±4.9%)显著大于狒狒(17±2.9%)(P < 0.05)。在40分钟CAO和4 - 7天CAR后,猪的IF/AAR为46±3.6%,而狒狒的IF/AAR最小,即2±0.6%。因此,猪和狒狒的冠状动脉侧支循环最少,但清醒狒狒的梗死面积明显小于清醒猪。这些差异可能部分由自然保护机制和/或灵长类动物较少的再灌注损伤来解释。灵长类动物的这些结果也可能有助于解释CAR在患者中的有益作用,其作用时间间隔比在其他实验动物中证明有益的时间更长。