Dissociation between two-dimensional echocardiographic left ventricular wall motion and myocardial salvage in early experimental acute myocardial infarction in dogs.
Dissociation between two-dimensional echocardiographic left ventricular wall motion and myocardial salvage in early experimental acute myocardial infarction in dogs.
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犬早期实验性急性心肌梗塞二维超声心动图左心室壁运动与心肌挽救之间的分离。
DOI：
10.1016/s0002-9149(84)80224-6
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Parisi,AF
中科院分区：
文献类型：
--
作者：
Hammerman,H;O'Boyle,JE;Cohen,C;Kloner,RA;Parisi,AF
本研究旨在评估是否可以通过以类似于临床使用的方式应用的二维（2-D）超声心动图在梗死后的早期检测到使用或不使用药物的冠状动脉再灌注的影响。对 24 只狗进行近端左前降支冠状动脉闭塞，然后将这些狗随机分为 3 组。第1组（n = 8），冠状动脉闭塞维持6小时；在第2组（n = 8）中，冠状动脉闭塞维持2小时，然后再灌注4小时；在第 3 组（n = 8）中，冠状动脉闭塞 2 小时后进行 4 小时再灌注，但在冠状动脉闭塞后 15 分钟也给予甲泼尼龙（30 mg/kg 静脉注射）。 6 小时时，通过闭合胸壁获得二维图像，并在 4 个短轴水平确定左心室壁运动异常的百分比。通过体内 Monastral 蓝注射和氯化三苯基四唑染色来确定处于危险中的肿块。第 1 组的坏死质量为危险质量的 74 ± 4%（平均值±平均值的标准误差），第 2 组和第 3 组的坏死质量较小，分别为 44 ± 6% 和 35 ± 4%（p<0.01）。第 1 组左心室坏死百分比为 22±3%，第 2 组为 15±3%（差异不显着），第 3 组为 10±2%（与第 1 组相比，p<0.05）。第 1 组的室壁运动异常百分比为 26 ± 1%，第 2 组为 26 ± 1%，第 3 组为 25 ± 2%。因此，在再灌注的早期阶段，通过 2-D 超声心动图室壁运动分析无法检测到显着的组织挽救。
This study was designed to evaluate whether the effects of coronary reperfusion with or without a pharmacologic agent could be detected in the early hours after infarction by 2-dimensional (2-D) echocardiography applied in a manner analogous to its clinical use. Proximal left anterior descending coronary occlusion was performed in 24 dogs, and the dogs were then randomized into 3 groups. In group 1 (n = 8), coronary occlusion was maintained for 6 hours; in group 2 (n = 8), coronary occlusion was maintained for 2 hours and was followed by 4 hours of reperfusion; in group 3 (n = 8), 2 hours of coronary occlusion were followed by 4 hours of reperfusion but methylprednisolone (30 mg/kg intravenously) was also administered 15 minutes after coronary occlusion. At 6 hours, 2-D images were obtained through the closed chest wall and the percentage of the left ventricular wall motion abnormalities was determined at 4 short-axis levels. The mass at risk was defined by in vivo Monastral blue injection and infarction by triphenyltetrazolium chloride staining. The mass of necrosis was 74 ± 4% (mean ± standard error of the mean) of the mass at risk in group 1 and was smaller in groups 2 and 3, 44 ± 6% and 35 ± 4%, respectively (p<0.01). Percent necrosis of the left ventricle was 22±3% in group 1, 15±3% in group 2 (difference not significant) and 10±2% in group 3 (p<0.05 vs group 1). Percent wall motion abnormalities were 26 ± 1% for group 1, 26 ± 1% for group 2 and 25 ± 2% for group 3. Thus, significant tissue salvage could not be detected during the early stages of reperfusion by 2-D echocardiographic wall motion analysis.