Effect of myocardial ischemia on hemodynamic response to carotid occlusion.
Effect of myocardial ischemia on hemodynamic response to carotid occlusion.
复制标题
心肌缺血对颈动脉闭塞血流动力学反应的影响。
DOI：
10.1152/ajpheart.1989.256.3.h672
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
Marsh,DH
中科院分区：
文献类型：
--
作者：
Billman,GE;Marsh,DH
将十四只杂种狗麻醉并用仪器测量动脉压（AP）、左心室压力（LVP）、主动脉血流量和心率（HR）。液压封堵器放置在左前降支（LAD，n = 9）和左回旋支（LCC，n = 14）冠状动脉周围。在前部（LAD 闭塞）或后部（LCC 闭塞）缺血之前和期间进行双侧颈动脉闭塞（BCO）。后部缺血显着（P 小于 0.01）降低了 BCO 引起的平均 AP（增加 44.3 +/- 7.3%）、收缩期 LVP（增加 65.5 +/- 6.9%）、LVP 一阶导数（dLVP/dt，增加 95.7 +/- 44.3%）和主动脉阻力（增加 117.7 +/- 26.9%）。相比之下，前部缺血未能显着改变 BCO 的血流动力学反应。双侧迷走神经切断术减弱或消除了后部缺血对 BCO 反应的许多影响。事实上，主动脉阻力的变化不再受到缺血的影响，并且增加到相同程度，如对照 BCO 期间所注意到的。然而，与对照（无冠状动脉闭塞）反应相比，平均 AP (38.7 +/- 6.8%)、收缩期 LVP (40.3 +/- 8.7%) 和 dLVP/dt (62.4 +/- 11.0%) 仍然显着降低。这些数据表明：1) 后部缺血比前部缺血引起 BCO 反应更大程度的降低，2) 迷走神经传入以及收缩功能的抑制可能都有助于后部缺血期间注意到的 BCO 反应抑制。
Fourteen mongrel dogs were anesthetized and instrumented to measure arterial pressure (AP), left ventricular pressure (LVP), aortic blood flow, and heart rate (HR). Hydraulic occluders were placed around the left anterior descending (LAD, n = 9) and left circumflex (LCC, n = 14) coronary arteries. A bilateral carotid occlusion (BCO) was made before and during either anterior (LAD occlusion) or posterior (LCC occlusion) ischemia. Posterior ischemia significantly (P less than 0.01) reduced the BCO-induced increases in mean AP (by 44.3 +/- 7.3%), systolic LVP (by 65.5 +/- 6.9%), first derivative of LVP (dLVP/dt, by 95.7 +/- 44.3%), and aortic resistance (by 117.7 +/- 26.9%). In contrast, anterior ischemia failed to alter significantly the hemodynamic response to BCO. Bilateral vagotomy attenuated or eliminated many of the effects of posterior ischemia on the BCO response. In fact, the change in aortic resistance was no longer affected by the ischemia and increased to the same extent, as noted during the control BCO. However, mean AP (38.7 +/- 6.8%), systolic LVP (40.3 +/- 8.7%), and dLVP/dt (62.4 +/- 11.0%) remained significantly reduced when compared with the control (no coronary occlusion) response. These data suggest that 1) posterior ischemia elicits a greater reduction in the BCO response than anterior ischemia, and 2) vagal afferents as well as depression of contractile function may both contribute to the BCO response inhibition noted during posterior ischemia.