Improvement for myocardial preservation using extracorporeal shock wave

体外冲击波对心肌保存的改进

• 批准号: 17591477
• 负责人: TANOUE Yoshihisa
• 金额: $ 2.24万
• 依托单位: KYUSHU UNIVERCITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2005
• 资助国家: 日本
• 起止时间: 2005 至 2006
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17591477/
• 关键词: Cardioplegia; Extracorporeal shock wave; Cross-circulated system; 対外衝撃波; 血液交叉灌流モデル

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.

体外超声冲击波（SW）随超声种子在水中传播，可穿透人体组织，在体外可促进血管新生。体外冲击波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）是否减少接受ESW治疗的兔心脏的心肌梗死面积。第一组实验方案为：心脏停搏后，经ESW治疗3天后，取心脏，置于4℃ UW液中保存6小时。采用交叉循环系统进行再灌注。再灌注后1h，在工作模式准备状态下，左房压6 mmHg时测量主动脉血流速度（AoF）。心率为250/min，主动脉后负荷压固定为60 mmHg。ESW治疗组（L组）在6 mmHg压力下的AoF为125±10.7ml/min，未治疗组（C组）为102 ±24.4m1/min。体外冲击波治疗有改善心肌功能的趋势。60分钟时血清肌酸激酶同工酶（CK-MB）水平L组为5.0±0.8ng/min，C组为13.6±4.6ng/ml。120分钟时，L组CK-MB为6.6±1.3ng/ml，C组为23.4±9.4ng/ml。第二组为ESW治疗3天后结扎心脏左前降支，测量心肌梗死危险面积（%AAR）。L组和C组的%AAR分别为42%和46%。L组与C组之间无统计学差异。