PROGRESSIVE VENTRICULAR REMODELING IN RAT WITH MYOCARDIAL-INFARCTION
PROGRESSIVE VENTRICULAR REMODELING IN RAT WITH MYOCARDIAL-INFARCTION
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DOI：
10.1152/ajpheart.1991.260.5.h1406
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发表时间：
1991-05-01
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：
PFEFFER, JM;PFEFFER, MA;BRAUNWALD, E
左心室扩大对左心功能不全患者的生存有重要的预后意义。为了确定心肌梗死后大鼠左室重构和扩张的方式和程度，我们获得了早期和晚期的被动压力-体积关系、室壁硬度常数和质量。在中度和大面积心肌梗死中，随着炎症和水肿的发展，左心室重量增加，然后逐渐减少，形成一条细小的疤痕，由于残余心肌的代偿性肥大而恢复到正常值。所有有梗死灶的大鼠均有左室扩张，但程度因梗死灶的大小和持续时间而异。在梗死后早期，除中、大面积梗死组的低压区显著右移，小梗死区的高压区显著左移外，其余各梗死区的压力-体积关系均无明显变化。在炎症反应消退期间，所有梗死组均出现与梗死灶大小相关的左室扩张。随着疤痕形成的完成，小梗死组的大鼠左室扩大没有进展，而中、大梗死灶的大鼠左室扩大却进展得更快。所有梗死组大鼠早期室壁硬度均维持在正常值范围内，而中、大面积梗死组大鼠晚期室壁硬度明显降低，且与室壁扩大程度相关。体积/质量比(V/V(Wt))的变化在梗塞后晚期最为明显，在大面积梗塞的大鼠中，体积(增加)和质量(减少，然后增加)均有显著变化，V/V(Wt)进行性增加。
Ventricular dilatation may have important prognostic implications for the survival of patients with left ventricular (LV) dysfunction. To determine the manner and extent to which the left ventricle of the rat remodels and dilates after myocardial infarction, we obtained the passive pressure-volume relationships, chamber stiffness constants, and mass during both the early and late phases. In moderate and large infarcts as inflammation and edema developed, LV weight increased then progressively decreased as a thin scar formed, returning to normal values as a result of compensatory hypertrophy of the residual myocardium. LV dilatation occurred in all rats with infarcts but to different extents depending on infarct size and duration. In the early postinfarction phase, pressure-volume relationship was relatively unchanged in all infarct-size groups, except for significant rightward shift in low pressure range for rats with moderate and large infarcts and significant leftward shift in high pressure range for rats with small infarcts. During resolution of the inflammatory response, LV dilatation occurred in all infarct groups in relation to infarct size. As scar formation became complete, LV enlargement did not progress in rats with small infarcts but did so in rats with moderate and large infarcts. LV chamber stiffness remained within the range of normal values during the early phase in all rats with infarcts but decreased significantly during the late phase in rats with moderate and large infarcts in association with the extent of ventricular enlargement. Alterations in the volume-to-mass ratio (V/V(wt)) were most marked in the late postinfarction phase, wherein both volume (increased) and mass (decreased, then increased) changed dramatically and V/V(wt) progressively increased in rats with large infarcts.