Dependence of ventricular fibrillation propensity on coronary blood flow without myocardial ischemia.
Dependence of ventricular fibrillation propensity on coronary blood flow without myocardial ischemia.
复制标题
心室颤动倾向对无心肌缺血的冠状动脉血流的依赖性。
DOI：
10.1016/0002-8703(81)90134-4
复制
发表时间：
1981
影响因子：
4.8
通讯作者：
H. Kuida
中科院分区：
文献类型：
--
作者：
A. Kralios;W. Bugni;M. McDonnell;T. Tsagaris;H. Kuida
在 CBF 减少和随后的心肌缺氧的情况下，心室颤动阈值 (VFT) 的变化与冠状动脉血流量 (CBF) 相关。为了阐明在没有心肌缺氧的情况下 CBF 对 VFT 的影响，对 18 只开胸戊巴比妥麻醉的犬进行了如下研究，这些犬的心率、心输出量和平均全身动脉压 (SAP) 均受到统一控制：连续监测 CBF、冠状窦 O2 含量 (CcsO2) 以及心肌 O2 消耗。通过单刺激扫描技术确定的基线 VFT 为 33.0 ± 3.9 mA。 CBF指数（I）和VFT（n=18）的初始值呈正相关（VFTmA=0.8±0.245·CBFIml/min·100g−1LV；r=0.60，p<0.01）。然后通过随机顺序改变 SAP(n = 10)、左冠状动脉灌注压 (n = 7) 和动脉 O2 含量 (n = 10)，并在每一步确定 VFT，诱导逐步 CBFI 增量直至超过初始 131.5 ± 9.7 ml/min · 100g−1LV 的生存时间； CcsO2 保持在 5.5 vol% 以上，而 CBFI 和 VFT 变化呈正相关，VFTmA 的平均加权斜率= 16.6 ± 0.103 · CBFI ml/min · 100g−1LV (F = 0.82,p< 0.05)。全身或冠状动脉灌注压以及动脉或冠状窦 O2 含量似乎并不独立影响 VFT。结论是，即使在没有心肌缺氧的情况下，CBF 本身也是 VFT 的主要决定因素，从而决定先天性心律失常倾向。
Ventricular fibrillation threshold (VFT) changes have been linked to coronary blood flow (CBF) in the context of CBF reduction and subsequent myocardial hypoxia. To clarify the effect of CBF on VFT in the absence of myocardial hypoxia, 18 open-chest pentobarbital-anesthelized dogs with uniformly controlled heart rate, cardiac output, and mean systemic arterial pressure (SAP¯) were studied as follows: CBF, coronary sinus O2content (CcsO2), and thereby myocardial O2consumption were continuously monitored. Baseline VFT determined by the single stimulus scanning technique was 33.0 ± 3.9 mA. Initial values of CBF index (I) and VFT (n = 18) were positively correlated (VFTmA= 0.8 ± 0.245 · CBFI ml/min · 100g−1LV; r = 0.60,p< 0.01). Stepwise CBFI increments up to live times in excess of initial 131.5 ± 9.7 ml/min · 100g−1LV were then induced by changing in random order,SAP¯ (n = 10), left coronary perfusion pressure (n = 7), and arterial O2content (n = 10) with VFT determined at each step; CcsO2remained above 5.5 vol% while CBFI and VFT changes were positively correlated, and mean weighted slope of VFTmA= 16.6 ± 0.103 · CBFI ml/min · 100g−1LV (F = 0.82,p< 0.05). Systemic or coronary perfusion pressure and arterial or coronary sinus O2content did not appear to affect VFT independently. It is concluded that even in the absence of myocardial hypoxia, CBF itself is a major determinant of VFT and thereby of innate arrhythmogenic propensity.