Synchronized coronary venous retroperfusion: prompt improvement of left ventricular function in experimental myocardial ischemia.
Synchronized coronary venous retroperfusion: prompt improvement of left ventricular function in experimental myocardial ischemia.
复制标题
同步冠状静脉逆灌注：实验性心肌缺血时左心室功能的迅速改善。
DOI：
10.1016/s0735-1097(85)80391-0
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发表时间：
1985
影响因子：
24
通讯作者：
Corday,E
中科院分区：
文献类型：
--
作者：
Yamazaki,S;Drury,JK;Meerbaum,S;Corday,E
采用二维超声心动图检测实验性冠状动脉闭塞术后同步冠脉静脉回灌注动脉血对心功能的影响。18只闭胸麻醉犬，冠状动脉内球囊导管闭塞左前降支近端6小时。其中8只作为未经治疗的对照组。10只在闭塞后30分钟开始同步后灌注，闭塞后1小时中断治疗5分钟，以研究后灌注反应的快速性。定量超声分析获得左室低短轴段整体射血分数和局部收缩指标，包括节段性收缩面积变化、收缩壁增厚和舒张末期壁厚。阻断后6小时，对照组的射血分数从50.7±4.9%（平均±标准差）下降到28.1±7.7%（平均±标准差），但治疗组的抑郁程度明显降低（从55.9±5.2降至41.8±9.3%）（p < 0.01）。阻断30 min时，两组缺血区分数面积变化均明显下降，阻断后，对照组犬的功能障碍持续存在，但在阻断6 h时，后灌注从6.0±6.5降至35.9±15.9%，基本逆转（p < 0.01）。阻断后1小时短暂中断后灌注，缺血区分数面积变化由33.0±14.9降至12.2±9.5% （p < 0.01）。当恢复后灌注时，这种下降迅速逆转为33.6±12.2%。节段壁增厚也有类似的趋势。与先前观察到的突然再灌注紊乱相比，再灌注不会导致缺血区舒张壁厚度增加，也与心律失常无关。因此，同步后灌注在急性冠状动脉闭塞期间迅速恢复局部和整体心功能。
The effect of synchronized coronary venous retroper-fusion of arterial blood on cardiac function after experimental coronary occlusion was examined by two-dimensional echocardiography. In 18 closed chest anesthetized dogs, the proximal left anterior descending coronary artery was occluded for 6 hours with an intracoronary balloon catheter. Eight of these animals served as untreated controls. Ten were treated with synchronized retroperfusion initiated 30 minutes after occlusion, and treatment was interrupted for 5 minutes at 1 hour after occlusion for study of the rapidity of retroperfusion response. Quantitative echographic analysis yielded global ejection fraction and regional indexes of contraction in a low left ventricular short-axis section, including segmental systolic area change, systolic wall thickening and end-diastolic wall thickness.At 6 hours after occlusion, ejection fraction had decreased from 50.7 ± 4.9% to 28.1 ± 7.7% (mean ± standard deviation) in control dogs, but was significantly (p < 0.01) less depressed in treated dogs (from 55.9 ± 5.2 to 41.8 ± 9.3%). The ischemic zone fractional area change at 30 minutes of occlusion exhibited a marked depression in both groups, after which the dysfunction persisted in the control dogs, but was largely reversed with retroperfusion from 6.0 ± 6.5 to 35.9 ± 15.9% at 6 hours of occlusion (p < 0.01). Brief interruption of retroperfusion 1 hour after occlusion reduced ischemic zone fractional area change from 33.0 ± 14.9 to 12.2 ± 9.5% (p < 0.01). This depression was promptly reversed to 33.6 ± 12.2% when retroperfusion was resumed. Segmental wall thickening followed a similar trend.Compared with previously observed derangements of sudden reperfusion, retroperfusion did not result in increased diastolic wall thickness in the ischemic zone and was not associated with arrhythmias. Thus, synchronized retroperfusion rapidly restored regional as well as global cardiac function during acute coronary occlusion.