Restraining infarct expansion preserves left ventricular geometry and function after acute anteroapical infarction
Restraining infarct expansion preserves left ventricular geometry and function after acute anteroapical infarction
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DOI：
10.1161/01.cir.99.1.135
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发表时间：
1999-01-12
期刊：
影响因子：
37.8
通讯作者：
Edmunds, LH
中科院分区：
文献类型：
--
作者：
Kelley, ST;Malekan, R;Edmunds, LH
背景：急性心肌梗死的扩张预示着进行性左室扩张、功能恶化和早期死亡。本研究验证了抑制急性梗死扩张保留左室几何形状和静息功能的假设。方法和结果：23只羊在远端左前降支和第二对角冠状动脉周围放置陷阱。在12只羊中，在预期的心肌梗死上放置马尔克斯网防止梗死变形，10至14天后闭塞陷阱动脉。连续血流动力学测量和经膈定量超声心动图在根尖前梗死后8周内获得0.23左室肿块。在装有网状物的绵羊中，循环血流动力学、卒中功和收缩末期弹性在梗死后1周恢复到梗死前的值，此后没有变化。心室容积和射血分数在梗死后第一周后没有变化。对照组动物出现较大的心尖前动脉瘤，左室扩张增加，循环血流动力学和心室功能进行性恶化。在第8周，左室舒张末期压、心输出量、舒张末期和收缩末期容积、射血分数、搏功和收缩末期弹性的差异具有显著性(P
Background-Expansion of an acute myocardial infarction predicts progressive left ventricular (LV) dilatation, functional deterioration, and early death. This study tests the hypothesis that restraining expansion of an acute infarction preserves LV geometry and resting function.Methods ann Results-In 23 sheep, snares were placed around the distal left anterior descending and second diagonal coronary arteries. In 12 sheep, infarct deformation was prevented by Marlex mesh placed over the anticipated myocardial infarct, Snared arteries were occluded 10 to 14 days later. Serial hemodynamic measurements and transdiaphragmatic quantitative echocardiograms were obtained up to 8 weeks after anteroapical infarction of 0.23 of LV mass. In sheep with mesh, circulatory hemodynamics, stroke work, and end-systolic elastance return to preinfarction values 1 week after infarction and do not change subsequently. Ventricular volumes and ejection fraction do not change after the first week postinfarction. Control animals develop large anteroapical ventricular aneurysms, increasing LV dilatation, and progressive deterioration in circulatory hemodynamics and ventricular function. At week 8, differences in LV end-diastolic pressure, cardiac output, end-diastolic and end-systolic volumes, ejection fraction, stroke work, and end-systolic elastance are significant (P