Prolonged Nonpulsatile Left Heart Bypass Diminishes Vascular Contractility
Prolonged Nonpulsatile Left Heart Bypass Diminishes Vascular Contractility
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长时间的非搏动性左心搭桥会降低血管收缩力
DOI：
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发表时间：
1999
影响因子：
1.7
通讯作者：
H. Takano
中科院分区：
文献类型：
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作者：
T. Nishimura;E. Tatsumi;T. Nishinaka;Y. Taenaka;M. Nakata;H. Takano
我们研究了长时间非搏动性左心搭桥（LHB）患者血管系统可能伴随形态学改变的功能变化。3只成年山羊行搏动性LHB。术后2周，将脉动性心室辅助装置更换为离心泵，随后进行4周的无脉动性LHB。在搏动性和非搏动性LHB期间，平均主动脉脉压分别为39和16 mmHg。在搏动性LHB （PUL）和非搏动性LHB （NP1w、NP2w、NP3w、NP4w）结束时测量全身血管阻力（SVR）和血浆去甲肾上腺素水平。在每个点注射50 μg/kg硝酸甘油和1μg/kg去甲肾上腺素，计算注射后SVR的最小值和最大值，作为反映血管张力和收缩性的参数。在整个过程中，SVR和血浆nor -肾上腺素水平没有显著变化（SVR: 1106、895、982、920和938达因·秒·厘米−5；去甲肾上腺素水平：0.3、0.2、0.1、0.2 ng/ml；在PUL、NP1w、NP2w、NP3w和NP4w）。注射硝酸甘油后SVR的最小值保持不变，表明血管张力在整个过程中保持稳定（分别为618、687、623、560、653达因·秒·cm−5）。在NP3w和NP4w注射去甲肾上腺素后，SVR的最大值分别为1695和1759 dyne·sec·cm−5，与PUL （2346 dyne·sec·cm−5）相比显著降低。结果表明，长时间无搏动左心搭桥不影响血管张力，但明显降低血管收缩力。
We investigated possible functional changes in the vascular system accompanying the morphological change in prolonged nonpulsatile left heart bypass (LHB). Three adult goats underwent pulsatile LHB. Two weeks postoperatively, the pulsatile ventricular assist device was replaced with a centrifugal pump and nonpulsatile LHB was subsequently conducted for 4 weeks. The mean aortic pulse pressure was 39 and 16 mmHg during the pulsatile and nonpulsatile LHB, respectively. Systemic vascular resistance (SVR) and plasma norepinephrine levels were measured at the end of pulsatile LHB (PUL), and at the end of 1st, 2nd, 3rd, and 4th week of nonpulsatile LHB (NP1w, NP2w, NP3w, NP4w, respectively). At each point, 50 μg/kg nitroglycerin and 1μg/kg norepinephrine were injected and the minimal and maximal values of SVR after injection were calculated as parameters reflecting the vascular tonus and contractility. The SVR and plasma nor epinephrine level did not significantly change during the entire course (SVR: 1106, 895, 982, 920, and 938 dyne·sec·cm−5; norepinephrine level: 0.3, 0.2, 0.1, 0.2, and 0.1 ng/ml; at PUL, NP1w, NP2w, NP3w, and NP4w, respectively). The minimal value of SVR after nitroglycerin injection remained unchanged, indicating that vascular tonus was stable during the entire course (618, 687, 623, 560, 653 dyne·sec·cm−5, respectively). In contrast, the maximal value of SVR after norepinephrine injection at NP3w and NP4w (1695 and 1759 yne·sec·cm−5) became significantly reduced compared to that at PUL (2346 dyne·sec·cm−5). These results indicated that prolonged nonpulsatile left heart bypass did not affect the vascular tonus, but significantly diminished the vascular contractility.
影响因子：
20.1
作者：
ASAKURA, T;KARINO, T
通讯作者：
KARINO, T