No hypoperfusion is produced in the epicardium during application of myocardial topical negative pressure in a porcine model.
No hypoperfusion is produced in the epicardium during application of myocardial topical negative pressure in a porcine model.
复制标题
在猪模型中施用心肌局部负压期间，心外膜中没有产生灌注不足。
DOI：
10.1186/1749-8090-2-53
复制
发表时间：
2007-12-06
影响因子：
1.6
通讯作者：
Ingemansson, Richard
中科院分区：
文献类型：
--
作者：
Lindstedt, Sandra;Malmsjo, Malin;Ingemansson, Richard
局部负压（TNP），通常用于伤口治疗，已被证明可以增加血流量，刺激骨骼肌血管生成。我们先前已经表明，-50 mmHg的心肌TNP显著增加心肌中的微血管血流量。当TPN用于伤口治疗（骨骼和皮下组织）时，在伤口边缘附近观察到相对低灌注区。由TNP引起的低灌注被认为取决于组织密度、距负压源的距离和施加的负压量。当将TNP应用于心肌时，显著的、长期存在的低灌注区理论上可能导致缺血，并对心肌产生负面影响。本研究旨在阐明心肌TNP是否产生低灌注。6只猪接受正中胸骨切开术。将激光多普勒探头水平插入LAD区域的心肌中，深度约为1-2 mm。在应用TNP之前和之后测量微血管血流。在左前降支（LAD）闭塞前（正常心肌）和LAD闭塞20分钟后（缺血心肌）进行分析。-50 mmHg的TNP诱导正常心肌中微血管血流量的显著增加（**p = 0.01），而-125 mmHg没有显著改变微血管血流量。在缺血心肌中，-50 mmHg的TNP诱导微血管血流量显著增加（*p = 0.04），而-125 mmHg未显著改变微血管血流量。心肌TNP时，无论是正常心肌还是缺血心肌，心外膜均未见低灌注。
Topical negative pressure (TNP), commonly used in wound therapy, has been shown to increase blood flow and stimulate angiogenesis in skeletal muscle. We have previously shown that a myocardial TNP of -50 mmHg significantly increases microvascular blood flow in the myocardium. When TPN is used in wound therapy (on skeletal and subcutaneous tissue) a zone of relative hypoperfusion is seen close to the wound edge. Hypoperfusion induced by TNP is thought to depend on tissue density, distance from the negative pressure source, and the amount negative pressure applied. When applying TNP to the myocardium, a significant, long-standing zone of hypoperfusion could theoretically cause ischemia, and negative effects on the myocardium. The current study was designed to elucidate whether hypoperfusion was produced during myocardial TNP. Six pigs underwent median sternotomy. Laser Doppler probes were inserted horizontally into the heart muscle in the LAD area, at depths of approximately, 1–2 mm. The microvascular blood flow was measured before and after the application of a TNP. Analyses were performed before left anterior descending artery (LAD) occlusion (normal myocardium) and after 20 minutes of LAD occlusion (ischemic myocardium). A TNP of -50 mmHg induced a significant increase in microvascular blood flow in normal myocardium (**p = 0.01), while -125 mmHg did not significantly alter the microvascular blood flow. In ischemic myocardium a TNP of -50 mmHg induced a significant increase in microvascular blood flow (*p = 0.04), while -125 mmHg did not significantly alter the microvascular blood flow. No hypoperfusion could be observed in the epicardium in neither normal nor ischemic myocardium during myocardial TNP.