Graded Global Ischemia and Reperfusion: Cardiac Function and Lactate Metabolism
Graded Global Ischemia and Reperfusion: Cardiac Function and Lactate Metabolism
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分级整体缺血和再灌注：心脏功能和乳酸代谢
DOI：
10.1161/01.cir.55.6.864
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发表时间：
1977
期刊：
影响因子：
37.8
通讯作者：
W. Hood
中科院分区：
文献类型：
--
作者：
C. Apstein;L. Deckelbaum;M. Mueller;L. Hagopian;W. Hood
在离体大鼠工作心脏上，研究了不同程度的全脑缺血和再灌注对心脏功能的影响。通过将8 ml/min的对照总冠状动脉流量降低至0、0.04、0.4或0.8 ml/min持续30分钟，诱导四度缺血，之后将冠状动脉流量恢复至对照水平。严重缺血后（0和0.04 ml/min缺血冠脉流量组），收缩力恢复到对照组的30%以下，心室发展压力和dP/dt的缺血前值，出现不可逆的心脏挛缩和起搏阈值升高。中度缺血后（0.4和0.8ml/min缺血冠脉流量组），心肌收缩功能完全恢复，缺血性挛缩迅速可逆，起搏阈值不增加。中度缺血组能够在30分钟缺血期内以稳定的低水平收缩性发挥作用，而严重缺血组则没有收缩活性。计算的组织乳酸累积量与不可逆缺血损伤的发生相关;再灌注后未能恢复的严重缺血组累积的乳酸是完全恢复的中度缺血组的3-5倍。结果表明，相对较小的差异，在缺血性疾病的严重程度可以显着影响组织损伤的程度。
The effect of global ischemia of different degrees of severity and reperfusion was studied in the isolated working rat heart. Four degrees of ischemia were induced by reducing the control total coronary flow of 8 ml/min to 0, 0.04, 0.4, or 0.8 ml/min for 30 minutes, after which the coronary flow was returned to the control level. After severe ischemia (0 and 0.04 ml/min ischemic coronary flow groups), recovery of contractility was to less than 30% of the control, pre-ischemic value of ventricular developed pressure and dP/dt, and irreversible cardiac contracture and an increised pacing threshold occurred. After moderate ischemia (0.4 and 0.8 ml/min ischemic coronary flow groups), contractile function recovered com- pletely, ischemic contracture was rapidly reversible and the pacing threshold did not increase. The moderately ischemic groups were able to function at a stable, low level of contractility for the 30 minute ischemic period, whereas the severely ischemic groups had no contractile activity. The amount of calculated tissue lactate accumulation correlated with the occurrence of irreversible ischemic injury; the severely ischemic groups which failed to recover with reperfusion accumulated 3-5 times as much lactate as the moderately ischemic groups which recovered completely. The results suggest that relatively small differences in the severity of the ischemic condition can markedly affect the degree of tissue injury.