Coronary sinus occlusion enhances coronary collateral flow and reduces subendocardial ischemia
Coronary sinus occlusion enhances coronary collateral flow and reduces subendocardial ischemia
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DOI：
10.1152/ajpheart.2001.280.3.h1361
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发表时间：
2001-03-01
影响因子：
4.8
通讯作者：
Kikuchi, K
中科院分区：
文献类型：
--
作者：
Ido, A;Hasebe, N;Kikuchi, K
在冠状静脉窦结扎(CSO)可减轻心肌缺血的假设下，观察了CSO对犬冠脉侧支循环血流量和局部心肌血流量(RMBF)分布的影响。38只麻醉犬阻断冠状动脉左前降支，同时或不阻断CSO，并保持完整的血管收缩张力。分别测定心内膜下(Endo)和心外膜下(Epi)的RMBF和心肌内压(IMP)。在血管舒缩张力不变的情况下，CSO可显著增加缺血区(IR)的RMBF，尤其是Endo，从0.17+/-0.03升至0.33+/-0.05毫升。分钟(-1)。G(-1)(P<；0.05)，Endo/Epi由0.59+/-0.10增加到1.15+/-0.15(P<；0.01)。腺苷可部分消除CSO的上述作用。但Endo/Epi仍由0.90+/-0.13升至2.09+/-0.30(P<；0.01)。胰岛素抵抗时RMBF的变化与CSO时CS峰值压显著相关。胰岛素抵抗时IMP的Endo/Epi在CSO时明显降低。综上所述，CSO有可能增加冠脉侧支循环，保护缺血心肌，尤其是在Endo。
On the hypothesis that coronary sinus occlusion (CSO) may reduce myocardial ischemia, we examined the effects of CSO on coronary collateral blood flow and on the distribution of regional myocardial blood flow (RMBF) in dogs. Thirty-eight anesthetized dogs underwent occlusion of the left anterior descending coronary artery with or without CSO and intact vasomotor tone. We measured RMBF and intramyocardial pressure (IMP) in the subendocardium (Endo) and subepicardium (Epi) separately. With intact vasomotor tone, CSO during ischemia significantly increased RMBF in the ischemic region (IR), particularly in Endo from 0.17 +/- 0.03 to 0.33 +/- 0.05 ml . min(-1) . g(-1) (P< 0.05), and increased the Endo/Epi from 0.59 +/- 0.10 to 1.15 +/- 0.15 (P< 0.01). These effects of CSO were partially abolished by adenosine. However, the Endo/Epi was still increased from 0.90 +/- 0.13 to 2.09 +/- 0.30 (P< 0.01). The changes in RMBF in IR were significantly correlated with the peak CS pressure during CSO. The Endo/Epi of IMP in IR was significantly decreased during CSO. In conclusion, CSO potentially enhances coronary collateral flow, and preserves the ischemic myocardium, especially in Endo.