Matsui Y, Yamauchi H, Sutoh Y, Dudra J, Gou M, Yasuda K
Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Surg Today. 1998;28(11):1154-9. doi: 10.1007/s005950050303.
Although dynamic cardiomyoplasty (DCMP) is currently being evaluated as an alternative to end-stage congestive heart failure, the overall results of DCMP are variable and inconclusive. We evaluated the effect of classic DCMP on systolic and diastolic cardiac function in normal heart using reliable indicators which minimize the influences of load conditions. Six experimental dogs were evaluated with the acute nonpreconditioning model. The slope of the linear preload recruitable stroke work relationship (Mw) showed a significant increase with latissimus dorsi muscle (LDM) stimulation (postwrap non-stimulation 59.1+/-6.3, postwrap stimulation 98.6+/-9.7 erg cm(-3) x 10(3); P < 0.01), and the x-intercept (V0) was unchanged; these were utilized as the indicators of left ventricular systolic function. The constant of pressure decay (tau) increased after LDM wrap (prewrap 45.8+/-6.0, postwrap nonstimulation 69.3+/-10.3, postwrap stimulation 72.3+/-13.9 ms; P < 0.05), and the peak filling rate was unchanged after LDM wrap, which were utilized as the indicators of diastolic function. We concluded that classic dynamic cardiomyoplasty is effective in assisting systolic cardiac function, but may to some degree have a detrimental effect on the diastolic cardiac function.
尽管动态心肌成形术（DCMP）目前正被评估为终末期充血性心力衰竭的一种替代疗法，但DCMP的总体效果参差不齐且尚无定论。我们使用可靠指标评估了经典DCMP对正常心脏收缩和舒张功能的影响，这些指标将负荷条件的影响降至最低。采用急性非预处理模型对6只实验犬进行评估。线性前负荷可募集搏功关系（Mw）的斜率在刺激背阔肌（LDM）后显著增加（包裹后未刺激时为59.1±6.3，包裹后刺激时为98.6±9.7 erg cm⁻³×10³；P<0.01），而x轴截距（V0）未改变；这些被用作左心室收缩功能的指标。压力衰减常数（tau）在包裹LDM后增加（包裹前为45.8±6.0，包裹后未刺激时为69.3±10.3，包裹后刺激时为72.3±13.9 ms；P<0.05），且包裹LDM后峰值充盈率未改变，这些被用作舒张功能的指标。我们得出结论，经典动态心肌成形术在辅助心脏收缩功能方面有效，但可能在一定程度上对心脏舒张功能有不利影响。
