Improvement for myocardial preservation using extracorporeal shock wave

体外冲击波（SW）与超声水中的种子一起穿过人体组织，可以促进体外血管生成。ESW也被证明可以改善局部心肌血流量和心功能。本研究的目的是评估(1)ESW是否改善心肌再灌注损伤，(2)减少ESW治疗家兔心脏心肌梗死面积。第一种实验方案是在心脏骤停后采集接受ESW治疗3天的心脏，然后在4℃UW溶液中保存6小时。再灌注采用交叉循环系统。再灌注1小时后，在工作模式准备时，以6mmHg左房压（LAP）测量主动脉血流速率（AoF）。热率250/min，主动脉负荷后压60mmHg。ESW治疗组6mmHg LAP AoF为125±10.7ml/min （L组），非治疗组102±24.4m1/min （C组）。ESW治疗有改善心肌功能的倾向。血清肌酸激酶- mb (CK-MB) 60min时，L组为5.0±0.8ng/min， C组为13.6±4.6ng/ml。L组120min CK-MB为6.6±1.3ng/ml， C组为23.4±9.4ng/ml。第二组的方案是将接受ESW治疗3天的心脏左前降支结扎，测量心肌梗死危险面积率（%AAR）。L组和C组的%AAR分别为42%和46%。L组与C组间无统计学差异。

Extracorporeal shock wave (SW) travels with the seed in water of ultrasound through body tissue, and could enhance angiogenesis in vitro. ESW has also been demonstrated to improve the local myocardial blood flow and cardiac function. The purpose of this study is to assess (1) whether ESW improves myocardial reperfusion injury, and (2) reduces the myocardial infarct size in the rabbit heart that received ESW therapy. The experimental protocol in the first was that the heart received ESW therapy for 3 days was harvested after cardioplegic arrest,and then stored in UW solution for 6 hours in 4℃. Reperfusion was performed using cross-circulation system. One hour after reperfusion, the aortic flow rate (AoF) was measured at left atrial pressure ( LAP) of 6mmHg in the working mode preparation. The heat rate was paced at 250/min, and the aortic afterload pressure was fixed at 60mmHg. The AoF at LAP of 6mmHg was 125±10.7ml/min in ESW therapy group ( L group) and 102 ±24.4m1/min in non-therapy group ( C group). ESW therapy has the tendency to improve myocardial function. Serum creatine kinase-MB ( CK-MB) on 60minute was 5.0±0.8ng/min in L group and 13.6±4.6ng/ml in C group, respectively. CK-MB on 120minute was 6.6±1.3ng/ml in L group and 23.4±9.4ng/ml in C group, respectively. The protocol in the second was that the left anterior descending artery of the heart received ESW therapy for 3 days was ligated, and we measured the rate of myocardial infarct area at risk (%AAR). The %AAR in L and C groups was 42% and 46%, respectively. There was no statistical difference between L and C groups.