Arnulf G
Arch Mal Coeur Vaiss. 1976 Aug;69(8):801-8.
The author presents the results of prolonged research into ventricular fibrillation during myocardial ischaemia, both from the electrocardiographic and biochemical standpoints. - He emphasises the successive tonic and atonic features of VF due to ischaemia, and the difference between the fibrillation in an ischaemic area and in a control area. The most original concept is that there is often a difference between the onset of VF in an ischaemic zone and in a control zone. This study has been carried out with both acute and progressive ischaemia. - The biochemical studies were carried out on blood samples taken from the origin of the coronary arteries, the coronary veins, and from the saphenous veins. An important finding was the definite increase in the potassium level of the coronary venous blood in proportion to the degree of ischaemia; the sodium level showed little change, and if anything tended to fall. But the most important and distinctive finding was that at the onset of VF the sodium and potassium concentrations in the coronary venous blood suddenly increase. As the VF continues, there is a progressive increase in lactic acid and a fall in pH, which is maximal at the onset of the VF. These findings are valid under normothermic conditions, and when there is no extracorporeal circulation. - The physiopathological and practical implications of these facts are discussed.
作者从心电图和生化角度介绍了对心肌缺血期间心室颤动的长期研究结果。——他强调了缺血性室颤相继出现的强直性和弛缓性特征,以及缺血区域和对照区域颤动之间的差异。最具原创性的概念是,缺血区和对照区室颤的发作往往存在差异。这项研究是在急性和进行性缺血情况下进行的。——生化研究是对取自冠状动脉起始处、冠状静脉和大隐静脉的血样进行的。一个重要发现是冠状静脉血中的钾水平随着缺血程度的增加而明显升高;钠水平变化不大,甚至有下降趋势。但最重要且独特的发现是,在室颤发作时,冠状静脉血中的钠和钾浓度会突然升高。随着室颤持续,乳酸逐渐增加,pH值下降,在室颤发作时达到最大值。这些发现在常温条件下且无体外循环时是成立的。——文中讨论了这些事实的生理病理及实际意义。