Myocardial lactate metabolism during pacing induced angina pectoris.
Myocardial lactate metabolism during pacing induced angina pectoris.
复制标题
起搏诱发心绞痛期间心肌乳酸代谢。
DOI：
--
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发表时间：
1983
影响因子：
2.1
通讯作者：
E. Thaulow
中科院分区：
文献类型：
--
作者：
H. Ihlen;S. Simonsen;E. Thaulow
本文对20例冠心病患者心房起搏诱发轻度心绞痛时及发作后即刻的心肌乳酸代谢进行了研究。心肌乳酸提取率（MLE）从心绞痛前的0.27 ± 0.03（SEM）降至心绞痛期间的0.01 ± 0.06，起搏后15秒进一步降至-0.32 ± 0.11。8例患者在起搏期间和13例患者在起搏后发现乳酸产生。其中8例患者采用热稀释法测量心脏静脉血流量。起搏后15秒，“缺血性乳酸净流出量”增加了23 +/- 4 mumol/min，而“非缺血区域的乳酸摄取量”减少了11 +/- 2 mumol/min。起搏后15分钟，所有左前降支冠状动脉（LAD）次全狭窄的患者均显示乳酸产生，而在左前降支闭塞和狭窄后区侧支循环的患者中观察到的频率较低。在早期恢复期，缺血心肌代谢产物的洗脱增加是该方法检测缺血的灵敏度相当高的主要原因。与早期研究相比，这允许更短的起搏周期和更少的疼痛。在20分钟和45分钟恢复期后，MLE和心电图变化具有相同的重现性。
Myocardial lactate metabolism was studied in 20 patients with coronary heart disease during and immediately after slight angina pectoris induced by atrial pacing. Myocardial lactate extraction ratio (MLE) decreased from 0.27 +/- 0.03 (SEM) before angina to 0.01 +/- 0.06 during angina, and further to -0.32 +/- 0.11 at 15 sec after pacing. Lactate production was found to occur in eight patients during pacing and 13 patients after pacing. Cardiac venous flow was measured by thermodilution in eight of these patients. 'Net ischaemic lactate efflux' increased by 23 +/- 4 mumol/min 15 sec after pacing, whereas 'lactate uptake in non-ischaemic regions' diminished by 11 +/- 2 mumol/min. Lactate production 15 min after pacing was revealed in all patients with subtotal stenosis of the left anterior descending coronary artery (LAD), whereas it was less frequently observed in patients with occluded LAD and collaterals to the post-stenotic area. Increased washout of metabolites from the ischaemic myocardium during the early recovery period is the main reason for the rather high sensitivity of ischaemia detection by this procedure. This permits shorter pacing periods and less pain than in earlier studies. Both MLE and electrocardiographic changes were equally reproducible after 20 and 45 min recovery period.
DOI：
10.1016/0002-9149(81)90316-7
发表时间：
1981
期刊：
The American journal of cardiology
影响因子：
--
作者：
Fuchs,RM;Brinker,JA;Maughan,WL;Weisfeldt,ML;Yin,FC
通讯作者：
Yin,FC