The Evaluation of Transmyocardial Laser Revascularization with the aid of PET

PET辅助心肌激光血运重建术的评价

• 批准号: 09671371
• 负责人: CHIBA Yukio
• 金额: $ 1.86万
• 依托单位: Fukui Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671371/
• 关键词: Transmyocardial Laser Revascularization; Positron Emmision Tomography (PET); Matrix Metalloproteinase (MMP); Platelet-derived Endothelial Cell Growth Factor (PDECGF); Angiogenesis; Platelet-derived endothelial cell growth factor(PDECGF); positron em

(Method) Adult beagle dogs were anesthesized and ventilated mechanically with room air. A left thoracotomy was performed and a heart was exposed. Then the regional myocardial blood flow (RMBF) by the positron emmision tomography (PET) with ^<13>NH^3 was measured. Then the left anterior descending coronary artery was ligated just distal to the first diagonal branch and acute myocardial infarction was made. Then post-MI RMBF was measured by PET.The dogs were divided into two group ; control group and TMLR group. In the control group, thoracotomy was closed, And in the TMLR group, the transmural channels were created in the LAD territory by a CO2 laser. The channels in diameter about 1mm were made with a density of 1 channel / cm2, an average of 10 channels. Then RMBF was measured by PET, too. And the thoracotomy was closed. RMBF was measured two weeks and two monthes after the operation. Then the dogs were sucrificed and the hearts were excised. The tissue level of matrix metalloproteina … More se (MMP) and platelet-derived endothelial cell growth factor (PDECGF) was measured by the zymography and spectrophotometer. In additioon, the endothelial cells were stained by double immunohistochemical technique with antiPCNA antibody and anti-Factor VIII-related antibody, and then the microvessel density was evaluated. (Results) The rate of the absorbed level of 13NH3 in the infarcted territory to non-infarcted area was caluculated, and the value was evaluated as the percentage of the pre-infarcted one. In the control group, the value of post-infarction, 2 weeks and 2 monthes after operation were 25%, 62% and 49%. In the TMLR group, the value of post-infarction, post-TMLR, 2 weeks and 2monthes were 36%, 29%, 73% and 67%. There was no significant difference between the two groups, and TMLR did not increase regional blood flow in acute ischemic myocardium. Any completely patent channels were not found, and they were infiltrated with granulation tissue. A large amount of microvessels and proliferating endothelial cells were found around the channels. The level of MMP-2, MMP-9 and PDECGF increased in the infarcted territory. They are significantly higher in the TMLR group than in the control group. The microvessel dencity was significantly higher in the TMLR group than in the control group. (Conclusion) TMLR did not increased RMBF in the acute ischemic myocardium. Thecompletely patent channels were not found, and they were infiltrated with granulation tissue. TMLR could stimulate the angiogenesis with the expression of MMP and PDECGF. Less

（方法）成年比格犬麻醉后，采用室内空气机械通气。左开胸，露出心脏。然后用^<13> nh3正电子发射断层扫描（PET）测量心肌局部血流量（RMBF）。在第一斜支远端结扎左冠状动脉前降支，行急性心肌梗死。然后用PET测定心肌梗死后的RMBF。这些狗被分成两组；对照组和TMLR组。对照组闭合开胸，TMLR组采用CO2激光在LAD区域建立跨壁通道。直径约为1mm的通道密度为1个通道/ cm2，平均为10个通道。再用PET测定RMBF。开胸手术是关闭的。术后2周、2个月分别测定RMBF。然后这些狗被自杀，心脏被切除。采用酶谱法和分光光度计法测定基质金属蛋白（MMP）和血小板源性内皮细胞生长因子（PDECGF）的组织水平。采用抗pcna抗体和抗viii因子相关抗体双免疫组化技术对内皮细胞进行染色，并测定微血管密度。（结果）计算梗死区13NH3吸收水平与非梗死区13NH3吸收水平的比值，以梗死前13NH3吸收水平与非梗死区13NH3吸收水平的比值进行评价。对照组梗死后、术后2周、2月的评分分别为25%、62%、49%。TMLR组梗死后、TMLR后、2周和2个月的价值分别为36%、29%、73%和67%。两组间差异无统计学意义，TMLR不增加急性缺血心肌的局部血流量。未见完全通畅的通道，可见肉芽组织浸润。导管周围可见大量微血管和增殖的内皮细胞。梗死区MMP-2、MMP-9、PDECGF水平升高。TMLR组明显高于对照组。TMLR组微血管密度明显高于对照组。（结论）TMLR不增加急性缺血心肌的RMBF。未见完全通畅的通道，且有肉芽组织浸润。TMLR可通过MMP和PDECGF的表达刺激血管生成。少