A FLOW-DEPENDENT AND TIME-DEPENDENT INDEX OF ISCHEMIC-INJURY AFTER EXPERIMENTAL CORONARY-OCCLUSION AND REPERFUSION
A FLOW-DEPENDENT AND TIME-DEPENDENT INDEX OF ISCHEMIC-INJURY AFTER EXPERIMENTAL CORONARY-OCCLUSION AND REPERFUSION
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DOI：
10.1073/pnas.80.18.5784
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发表时间：
1983-01-01
期刊：
影响因子：
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通讯作者：
BRAUNWALD, E
中科院分区：
文献类型：
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作者：
DEBOER, LWV;RUDE, RE;BRAUNWALD, E
本研究的目的是确定缺血指数，表示为血流剥夺（FD）和阻塞持续时间（T）的乘积，FD × T。T与冠状动脉再灌注后内膜下心肌的生化和早期形态学改变相关，并可预测冠状动脉再灌注后不可逆损伤的最终发展。在犬模型的冠状动脉闭塞期间在体内获得了用于测量ATP和其他嘌呤以及用于超微结构研究的心肌活检样本，并被认为与冠状动脉再灌注后坏死的发展有关。FD ×T与ATP含量呈负相关[ATP，nmol/mg心脏蛋白= 23.6 - 0.24（FD × N）]。T）+0.0007（FD × T）T）2; r = -0.81]和半定量早期组织学损伤指数（r = 0.70）。值（FD ×T）< 18与可逆性损伤相关，即，冠状动脉再灌注后完全挽救。(FX. times. T）> 18与不同程度的坏死有关;坏死严重（78 . ±. ATP < 10 nmol/mg蛋白质和总嘌呤池减少50%时，内膜下活检标本中的12%。FD ×T与最终内膜下坏死百分比相关（r = 0.85）。因此，作为缺血性损伤的指标，FD ×T可能有助于评估缺血心肌组织是否会受益于缺血区域血流的早期恢复。
The purpose of the present study was to determine whether an ischemic index, expressed as the product of flow deprivation (FD) and the duration of occlusion (T), FD .times. T, correlated with biochemical and early morphologic alterations of the subendocardial myocardium and could predict ultimate development of irreversible injury after coronary reperfusion. Myocardial biopsy specimens for measurement of ATP and other purines and for ultrastructure studies were obtained in vivo during coronary occlusion in a canine model and were considered relative to development of necrosis after coronary reperfusion. FD .times. T correlated negatively with ATP content [ATP, nmol/mg of cardiac protein = 23.6 - 0.24(FD .times. T) + 0.0007(FD .times. T)2; r = -0.81] and with a semiquantitative early histologic index of damage (r = 0.70). Values of (FD .times. T) < 18 were associated with reversible injury, i.e., complete salvage after coronary reperfusion. (FX .times. T) > 18 was associated with varying degrees of necrosis; necrosis was severe (78 .+-. 12% of subendocardial biopsy specimens) when ATP < 10 nmol/mg of protein and total purine pool was decreased by 50%. FD .times. T correlated with the eventual percentage of subendocardial necrosis (r = 0.85). Accordingly, as an index of ischemic injury, FD .times. T may be useful in assessing whether ischemic myocardial tissue will benefit from early restoration of blood flow to the ischemic area.