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Evaluation of early treatments for acute myocardial infarction: Basic and co-operative studies

急性心肌梗死早期治疗的评价：基础研究和合作研究

基本信息

批准号：
60304061
负责人：
NAKAMURA Motoomi
金额：
$ 18.43万
依托单位：
KYUSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Co-operative Research (A)
财政年份：
1985
资助国家：
日本
起止时间：
1985 至 1987
项目状态：
已结题

项目摘要

1. Strateqies of the research group; Effectiveness and salutatory mechanism of the early treatment of acute myocardial infarction were studied experimentally in 10 institutions in Japan. The research projects of the group were constituted from both a cooperative study on the effects of reperfusion for tissue salvage from myocardial necrosis and independent studies relating to myocardial ischemia. The goal of the present study was 1) to elucidate the factors which determine the irreversible damage of the myocardium after ischemic insult, 2) to derive useful indexes representing sensitively the alterations of myocardial reversibility and 3) to establish the remedies to reduce myocardial necrosis.2. Co-operative study on the effects of reperfusion on ischemic myocardium ; Alterations of energy metabolism in vivo during myocardial ischemia or hypoxemia were determined spectrologically by NMR and early changes of intracellular pH were demonstrated (Imai, Hosoda). Effects of reperfusion on regional wall motion, incidnce of fatal arrhythmia, and intramyocardial pH after 3 hours of coronary occlusion were examined in anesthetized canine model using two dimensional echocardiography (Yazaki) or cardiomovegraphy (Tamura), electrophysiology (Sugimoto) and implantable pH sensors (Abiko), in which the level of wall motion and the size of myocardial necrosis or the amount of myosin light-chain kinase released was discordant early after reperfusion. A significant tissue salvage in a reperfusion group 24 hours after 90 minutes (Nakamura M) but not 3 hours (Nakamura Y) of coronary occlusion was demonstrated in a canine model. Shibata demonstrated some beneficial effects of a lipoxigenase antagonist on tissue salvage against reperfusion damage.

1.在日本的10个机构中对急性心肌梗死早期治疗的有效性和治疗机制进行了实验研究。该小组的研究项目由关于再灌注对心肌坏死组织挽救作用的合作研究和与心肌缺血有关的独立研究组成。本研究的目的是：1）阐明心肌缺血后不可逆损伤的决定因素; 2）获得敏感地反映心肌可逆性改变的指标; 3）建立减少心肌坏死的治疗方法.再灌注对缺血心肌影响的合作研究;通过NMR光谱测定心肌缺血或低氧血症期间体内能量代谢的变化，并证明细胞内pH的早期变化（Imai，Hosoda）。在麻醉犬冠状动脉闭塞3小时后，应用二维超声心动图（Yazaki）或心运动描记术（Tamura）、电生理学和心电图技术，观察了再灌注对局部室壁运动、致命性心律失常发生率和心肌内pH值的影响。（Sugimoto）和可植入pH传感器（Abiko），其中再灌注后早期室壁运动水平与心肌坏死面积或肌球蛋白轻链激酶释放量不一致。在犬模型中，在冠状动脉闭塞90分钟后24小时（中村M）而不是3小时（中村Y）的再灌注组中证明了显著的组织挽救。柴田证明了脂氧合酶拮抗剂对组织挽救对抗再灌注损伤的一些有益作用。