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Effectiveness of Coronary Sinus Retroinfusion on the Acute myocardial Ischemia.

冠状窦逆灌注治疗急性心肌缺血的有效性。

基本信息

批准号：
02454261
负责人：
WATANABE Tsutomu
金额：
$ 4.03万
依托单位：
AICHI MEDICAL UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1992
项目状态：
已结题

项目摘要

To evaluate the effects of retrograde administration of diltiazem into the ischemic myocardium using synchronized retroperfusion system (SRP), mongrel dogs were anestherized and the left anterior descending coronary artery was occluded for 3.5 hours. A triple lumen balloon tipped catheter for SRP was positioned in the great cardiac vein via the coronary sinus. After 30 minutes of coronary occlusion, dogs were randomly assigned into following 4 groups.Group A (n=5) : Coronary occlusion was maintained for following 3 hours without any treatment.Group B (n=9) : Coronary occlusion was maintained for 3 hours with intravenous infusion of diltiazem (3ug/kg/min).Group C (n=8) : SRP was initiated with intravenous infusion of diltiazem (3ug/kg/min) for 3 hours.Group D (n=9) : SRP was initiated with intracoronary-venous infusion of diltiazem (3ug/kg/min), infused into the extracorporeal circuit of SRP system, for 3 hours.Hemodynamic change, blood and myocardial concentration of diltiazem and infa … More rct sized, estimated by triphenylterazolium method, as a percent of risk area (estimated by blue dye method) were measured.Results : There was significant reduction in heart rate and suppression of the rise of left ventricular enddiastolic pressure with the time of lapse in the groups treated with diltiazem (B,C,D). There were no significant differences between the groups in systolic left ventricular pressure, pulmonary blood pressure and cardiac output. Diltiazem concentrations in the venous blood and the myocardium ( endocardial layr (End), epicardial layr (Epi) in the ischemic (I) and non-ischemic (N)) were tabulated (mean(〕SY.+-.〔)S.E., ^<**>p<0.05 v.s. group B) :The infarcted size in the group D was significantly smaller (43.2(〕SY.+-.〔)3.1%) compared with the group A(77.5(〕SY.+-.〔)2.5%) and B (78.9(〕SY.+-.〔)7.6%)(group C was 52.7(〕SY.+-.〔)5.9%, n.s.). These data indicate that retroinfusion of diltiazem using retroperfusion system can deliver diltiazem into the ischemic myocardium and reduce ultimate infarct size. Less

为评价同步化逆行灌流系统(SRP)逆行给予地尔硫卓对缺血心肌的影响，将杂种犬麻醉后阻断冠状动脉左前降支3.5h。经冠状静脉窦将三腔球囊导管置入心脏大静脉。冠脉阻断30min后，犬随机分为4组。A组(n=5)：冠状动脉闭塞持续3h，不作任何处理。B组(n=9)，静脉滴注地尔硫卓(3ug/kg/min)维持冠脉闭塞3h。C组(n=8)：静脉滴注地尔硫卓(3ug/kg/min)，持续3h。D组(n=9)：冠脉内静脉滴注地尔硫卓(3ug/kg/min)，持续3h。血流动力学变化地尔硫卓和INFA…的血药浓度和心肌浓度结果：地尔硫卓(B、C、D)组随时间延长心率明显减慢，左室舒张末压升高受到明显抑制。两组间左心室收缩压、肺压和心输出量无显著差异。地尔硫卓在静脉血和心肌中的浓度(缺血组和非缺血组的心内膜层(END)、心外膜层(EPI))列表(平均值()sy.+-.()S.E.，^&lt；**&gt；p&lt；0.05 vs B组：D组心肌梗死面积(43.2±3.1%)显著小于A组(77.5±2.5%)和B组(78.9±7.6%)(C组为52.7±5.9%)。这些数据表明，使用逆灌系统逆行输注地尔硫卓可以将地尔硫卓输送到缺血心肌中，并缩小最终的梗塞范围。较少