Increased regional end-diastolic wall thickness early after reperfusion: a sign of irreversibly damaged myocardium.
Increased regional end-diastolic wall thickness early after reperfusion: a sign of irreversibly damaged myocardium.
复制标题
再灌注后早期局部舒张末期壁厚度增加：心肌不可逆损伤的标志。
DOI：
10.1016/s0735-1097(84)80283-1
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发表时间：
1984
影响因子：
24
通讯作者：
Meerbaum,S
中科院分区：
文献类型：
--
作者：
Haendchen,RV;Corday,E;Torres,M;Maurer,G;Fishbein,MC;Meerbaum,S
研究冠状动脉闭塞和再灌注后早期左室舒张末期壁厚和收缩壁增厚的二维超声心动图测量结果，并与局部心肌梗死面积测量结果进行比较。25只闭锁胸麻左冠状动脉降支闭塞犬，闭塞时间I组为3 min (n = 4)， II组为20 min (n = 4)， III组为60 min (n = 5)， IV组为180 min （n = 12）。III组和IV组梗死面积采用氯化三苯四唑技术定量。冠状动脉闭塞后，在乳突正中超声短轴切片上，缺血区中心壁增厚被变薄所取代，在再灌注后60分钟内，除i组外，缺血区舒张末期壁厚从对照到冠状动脉闭塞期结束没有明显变化，除IV组外。再灌注后60分钟，I组和II组舒张壁厚度仅轻微增加（分别增加了7.2%和0.24%），但III组和IV组舒张壁厚度明显增加（分别增加了41%和50%）。缺血区舒张末期壁厚从再灌注前到再灌注后60分钟的变化百分比与相应节段心肌坏死量有很好的相关性（r = 0.936，估计标准误差= 11.4%）；节段性舒张末期壁厚增加超过25%通常伴有20%或更多的节段性坏死。综上所述，再灌注后早期局部舒张末期壁厚明显增加与心肌不可逆性损伤有关，可作为心肌抢救的指标。
Two-dimensional echocardiographic measurements of regional left ventricular end-diastolic wall thickness and systolic wall thickening were studied during coronary artery occlusion and early after reperfusion and compared with measurements of regional myocardial infarct size. In 25 closed chest anesthetized dogs with left anterior descending coronary artery occlusion followed by reperfusion, the occlusion period was 3 minutes in group I (n = 4), 20 minutes in group II (n = 4), 60 minutes in group III (n = 5) and 180 minutes in group IV (n = 12). Infarct size in groups III and IV was quantitated using the triphenyltetrazolium chloride technique.After coronary occlusion, wall thickening was replaced by thinning in the center of the ischemic region at the midpapillary echographic short-axis section, and no improvement in function occurred up to 60 minutes after reperfusion, except in group I. Ischemic zone enddiastolic wall thickness did not change significantly from control to the end of the coronary occlusion period, except Group IV. At 60 minutes after reperfusion, enddiastolic wall thickness increased only slightly in groups I and II (by 7.2 and 0.24%, respectively), but a marked increase was observed in groups III and IV (by 41 and 50%, respectively). The percent change in ischemic zone end-diastolic wall thickness from before reperfusion to 60 minutes after reperfusion correlated well with the amount of myocardial necrosis in corresponding segments (r = 0.936, standard error of estimate = 11.4%); an increase in segmental end-diastolic wall thickness of more than 25% was generally associated with 20% or more segmental necrosis.It is concluded that significantly increased regional end-diastolic wall thickness early after reperfusion is associated with irreversibly damaged myocardium, and this might be used as an index of myocardial salvage.