Study of ventricular assisted circulation aiming at new physiological control

针对新生理控制的心室辅助循环研究

• 批准号: 11470279
• 负责人: TAKANO Hisateru
• 金额: $ 7.87万
• 依托单位: National Cardiovascular Center Research Institute
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-11470279/
• 关键词: Artificial heart; Ventricular assist; Autonomic nerve; Hormone; Central nervous system; Circadian rhythm; 定常流ポンプ; 心拍変動; 内分泌; 脳代謝; 液性調節因子; 全身末梢血管抵抗; 反受容体反射

We have conducted studies concerning physiological reactions to a long-term left heart assist with pulsatile or continuous left ventricular assist device, mainly by the use of animal experiments. We evaluated the cerebral circulatory metabolism and pathological changes of the central nervous system and its arteries under the circulation of a long-term left heart assist with pulsatile or continuous left ventricular assist device. The cerebral circulatory metabolism was not affected, and there were not observed remarkable pathological changes in the central nervous system and its arteries. As for autonomic nervous system, we investigated changes of heart rate variability (HRV) during long-term pulsatile and continuous flow left heart bypass in an animal study and found that a long-term left heart bypass exerts a different influence on HRV between pulsatile and continuous flow left heart bypass. The powers of the low frequency band (0.04-0.15 Hz; LF) and those of the high frequency band ( … More 0.15-0.40 Hz; HF) showed an increasing tendency during continuous flow left heart bypass, indicating an increase of cardiac vagal activity. During continuous flow left heart bypass, bradycardia phenomena, supposed to be caused by an increase of cardiac vagal activity, were often observed in animals with otherwise stable conditions. We also evaluated and found that there was no significant difference in plasma catecholamine level between the conditions under chronic pulsatile and continuous flow left heart bypass. Concerning systemic vascular resistance, we examined the constrictive function of the vascular system using vascular a-1 receptor agonist phenylephrine or norepinephrine administration. Prolonged continuous flow left heart bypass caused a significant decrease in systemic vascular resistance response to phenylephrine and norepinephrine, indicating a decrease of vasoconstrictive function although no remarkable change was not observed in systemic vascular resistance and its response during under prolonged pulsatile left heart bypass. Alternatively, systemic vascular resistance response to nitroglycerin injection showed no significant changes during pulsatile and continuous flow left heart bypass. Baroreceptor sensitivity was evaluated and it did not change significantly. We evaluated changes in circadian rhythm during prolonged pulsatile and continuous flow left heart bypass focusing on hormonal factors, body temperature, and aortic pressure. The circadian rhythm of melatonin and body temperature was not affected, while it was modified in the variations of hemodynamics-responsive renin and aortic pressure. Less

我们主要通过动物实验，对脉动或连续左心辅助装置长期左心辅助的生理反应进行了研究。我们评估了长期脉动或连续左心辅助装置循环下的脑循环代谢和中枢神经系统及其动脉的病理变化。脑循环代谢未受影响，中枢神经系统及其动脉未见明显病理改变。对于自主神经系统，我们在动物研究中研究了长期脉动和连续流左心绕道期间心率变异性（HRV）的变化，发现长期左心绕道对脉动和连续流左心绕道之间的HRV产生不同的影响。左心绕道连续血流期间，低频段（0.04-0.15 Hz；LF）和高频段（0.15-0.40 Hz；HF）的功率呈现增加趋势，表明心脏迷走神经活动增加。在连续血流左心搭桥期间，通常在状况稳定的动物中观察到心动过缓现象，这被认为是由心脏迷走神经活动增加引起的。我们还进行了评估，发现慢性搏动和连续流左心绕道手术条件下的血浆儿茶酚胺水平没有显着差异。关于全身血管阻力，我们使用血管a-1受体激动剂苯肾上腺素或去甲肾上腺素给药检查了血管系统的收缩功能。长时间连续血流左心旁路导致全身血管阻力对去氧肾上腺素和去甲肾上腺素的反应显着降低，表明血管收缩功能下降，尽管在长时间脉动左心旁路下没有观察到全身血管阻力及其反应的显着变化。或者，在脉动和连续血流左心搭桥期间，对注射硝酸甘油的全身血管阻力反应没有显示出显着变化。评估了压力感受器敏感性，结果没有显着变化。我们评估了长时间脉动和连续血流左心搭桥期间昼夜节律的变化，重点关注激素因素、体温和主动脉压。褪黑激素和体温的昼夜节律不受影响，但血流动力学反应性肾素和主动脉压的变化发生了改变。较少的

项目成果

Nikshinaka T., Tatsumi E., Nishimura T. et al: "Cardiac autonomic nervous function during long-term nonpulsatile left heart bypass"Artificial Organs. 23. 500-503 (1999)

Nikshinaka T.、Tatsumi E.、Nishimura T. 等人：“长期非搏动左心搭桥期间的心脏自主神经功能”人工器官。

Nishimura T, et al.: "Diminished vasoconstrictive function caused by long-term Nonpulsatile left heart bypass."Artificial Organs. 23(8). 722-726 (1999)

Nishimura T 等人：“长期非搏动性左心搭桥导致血管收缩功能减弱。”人工器官。

Nishinaka T, et al.: "Effect of prolonged nonpulsatile left heart bypass on vascular control status."J Artif Organs. 3(1). 34-38 (2000)

Nishinaka T 等人：“长期非搏动性左心搭桥对血管控制状态的影响。”J Artif Organs。

Nishinaka T., Tatsumi E., Nishimura T. et al: "Effects of reduced pulse pressure to the cerebral metabolism during prolonged nonpulsatile left heart bypass"Artifi Organs. 24. 676-679 (2000)

Nishinaka T.、Tatsumi E.、Nishimura T. 等人：“长时间非搏动性左心搭桥期间脉压降低对脑代谢的影响”Artifi Organs。

Nishinaka T, Koyanagi H, Tatsumi E, et al.: "Effect of prolonged nonpulsatile left heart on vascular control status"J Artif Organs. 3・1. 34-38 (2000)

Nishinaka T、Koyanagi H、Tatsumi E 等：“左心长时间无搏动对血管控制状态的影响”J Artif Organs 3・1（2000 年）。