Synchronously stimulated skeletal muscle graft for myocardial repair. An experimental study.
Synchronously stimulated skeletal muscle graft for myocardial repair. An experimental study.
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同步刺激骨骼肌移植用于心肌修复。
DOI：
10.1016/s0022-5223(19)37381-7
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Ray C.
中科院分区：
文献类型：
--
作者：
Michael L. Dewar;Davis C. Drinkwater;C. Wittnich;Ray C.
我们研究了用同步起搏骨骼肌移植物增强受损心肌的可行性。骨骼肌的收缩期较短，需要开发一种新的刺激器，以确保椎弓根移植物的收缩能够模拟心肌的收缩。每只狗将直肌和膈肌包裹在气球上，并与心电图同步进行电刺激，在收缩期间改变刺激电流和放电频率。为此，开发了一种原型混合刺激器，它可以感测心脏 R 波，并通过在收缩期内传递一系列不同频率的脉冲来调节骨骼肌的电输出。直肌和膈肌响应此类刺激的收缩特征相似，但前者由于肌肉体积较大而产生更高的最大张力。研究发现，方波输出比正弦波刺激更有效，持续 40 毫秒的单次刺激电脉冲产生的最大张力为 60 毫米汞柱，持续 120 毫秒，而 320 毫秒周期内的 4 个脉冲序列能够达到 100 毫米汞柱的最大张力，持续近 400 毫秒，后者接近心肌的张力。在另外六只狗中，直肌蒂移植物被用来替换在体外循环下切除的一部分左心室（左心室质量的25.5%±2.1%）。使用打开和关闭刺激器的左心室球囊研究左心室等长收缩。当骨骼肌移植物受到刺激时，左心室最大张力（+19.3% ±2.5%，p < 0.001，配对 t 检验）和左心室收缩力（+38.3% ±9.4%，p < 0.001）显着增强。因此，在这项初步研究中，适当定向和刺激的骨骼肌移植物能够在左心室心肌质量显着损失后增强左心室等长收缩功能。
We studied the feasibility of augmentation of impaired myocardium with synchronously paced skeletal muscle grafts. The short contractile period of skeletal muscle required development of a new stimulator to ensure that the pedicle graft contraction would simulate that of the myocardium. In four dogs each, rectus and diaphragmatic muscles were wrapped around a balloon and electrically stimulated in synchrony with the electrocardiogram, varying stimulation currents and frequency of discharge during systole. For this purpose, a prototype hybrid stimulator was developed which senses the cardiac R wave and modulates the electrical output to the skeletal muscle by delivering a train of impulses of varying frequencies within the systolic intervals. The contraction characteristics in response to such stimulation were similar in rectus and diaphragmatic muscles, but the former developed higher maximum tensions because of the greater muscle bulk. Square-wave output was found to be more effective than sine-wave stimulation, and a single stimulating electrical pulse of 40 msec duration produced a maximum tension of 60 mm Hg lasting for 120 msec, whereas a train of 4 pulses within a 320 msec period was able to achieve a maximum tension of 100 mm Hg lasting nearly 400 msec, the latter approximating that of the myocardium. In six other dogs, the rectus muscle pedicle graft was used to replace a segment of the left ventricle (25.5% ± 2.1% of left ventricular mass) excised under cardiopulmonary bypass. Left ventricular isometric contraction was studied using a left ventricular balloon with stimulators turned on and off. Significant augmentations of left ventricular maximum tension (+19.3% ±2.5%, p < 0.001, paired t test) and left ventricular contractility (+38.3% ±9.4%, p < 0.001) were achieved when the skeletal muscle grafts were stimulated. Thus, in this preliminary study, skeletal muscle graft properly oriented and stimulated is able to augment the left ventricular isometric contractile function after significant loss of left ventricular myocardial mass.
影响因子：
3.8
作者：
Pierce,WS;Myers,JL;Donachy,JH;Rosenberg,G;Landis,DL;Prophet,GA;Snyder,AJ
通讯作者：
Snyder,AJ