SURVIVAL AFTER AN EXPERIMENTAL MYOCARDIAL-INFARCTION - BENEFICIAL-EFFECTS OF LONG-TERM THERAPY WITH CAPTOPRIL
SURVIVAL AFTER AN EXPERIMENTAL MYOCARDIAL-INFARCTION - BENEFICIAL-EFFECTS OF LONG-TERM THERAPY WITH CAPTOPRIL
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DOI：
10.1161/01.cir.72.2.406
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发表时间：
1985-01-01
期刊：
影响因子：
37.8
通讯作者：
FINN, P
中科院分区：
文献类型：
--
作者：
PFEFFER, MA;PFEFFER, JM;FINN, P
尽管血管扩张剂治疗可以改善充血性心力衰竭患者的功能能力，但没有证据表明这种治疗可以延长生存期。大鼠的冠状动脉结扎用于产生各种大小的心肌梗塞以及由此产生的左心室功能障碍。为了确定心肌梗塞面积和长期生存之间的关系，并检验卡托普利长期治疗可以改善心肌梗塞后生存的假设，302 只大鼠在冠状动脉结扎后 14 天被随机分配接受安慰剂或卡托普利治疗。将动物饲养在层流装置中，每天进行随访，持续一年或直至自然死亡。通过左心室连续组织切片的平面测定法确定心肌梗塞的大小。安慰剂治疗大鼠的一年生存率显着下降，与梗塞面积的增加直接相关（从非梗塞大鼠的 71% 降至大面积梗塞大鼠的仅 8%）。长期卡托普利治疗可延长梗塞大鼠的生存期（P < 0.02）。中度梗塞动物的生存率改善最为显着，安慰剂治疗组大鼠的 1 年生存率为 21%，卡托普利治疗组大鼠的 1 年生存率为 48%。在这项心肌梗塞和左心室功能障碍的实验准备中，存活率与梗塞范围呈负相关。卡托普利的长期治疗可以改善左心室功能并减少梗塞慢性期的扩张，对延长慢性梗塞准备期的生存期也有显着效果。
Although vasodilator therapy improves functional capacity in patients with congestive heart failure, there is no evidence that such therapy can prolong survival. Coronary artery ligation in the rat was used to produce a wide range of myocardial infarct sizes and a resultant spectrum of left ventricular dysfunction. To determine the relationship between size of myocardial infarction and long-term survival and to test the hypothesis that long-term therapy with captopril could improve survival after myocardial infarction, 302 rats were randomly assigned to either placebo or captopril therapy 14 days after coronary artery ligation. The animals were kept in a laminar flow unit and followed daily for a 1 yr period or until spontaneous death. Size of myocardial infarction was determined by planimetry of serial histologic sections of the left ventricle. One yr survival in placebo-treated rats decreased markedly in direct relation to increasing size of infarction (from 71% in noninfarcted rats to only 8% in rats with large infarcts). Long-term captopril therapy prolonged the survival of rats with infarcts (P < 0.02). The most marked improvement in survival was noted in the animals with infarcts of moderate size, in which 1 yr survival was 21% in the placebo-treated rats and 48% in the captopril-treated rats. In this experimental preparation of myocardial infarction and left ventricular dysfunction, survival was inversely related to size of infarction. Long-term therapy with captopril, which improved left ventricular function and lessened dilatation in the chronic phase of infarction, also had a pronounced effect on prolonging survival in this preparation of chronic infarction.