Interrelationship between blood constituents and vessel wall during exacerbation and quiescence of myocardial ischemia.

心肌缺血恶化和静止期间血液成分与血管壁之间的相互关系。

• 批准号: 08457200
• 负责人: TOMOIKE Hitonobu
• 金额: $ 4.99万
• 依托单位: Yamagata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08457200/
• 关键词: acut myocardiol infarction; mortality; reperfusion therapy; lipoprotein; hypertriglyceridemia; ST alternans; ventricular fibrillation; ディファレンシャル・デイスプレイ; 急性期死亡; 冠攣縮; 内膜肥厚; 不安定狭心症; 冠動脈硬化; 粥腫; 血清コレステロール; 血清トリプリセライド; リポ蛋白質; 血小板

Early mortality and factors influencing it after acute myocardial infarction (AMI) were studied in Yamagata area from April 1993 to December 1995. Among 1014 patients with AMI,enrolled from 41 hospitals, 184 patients died within 28 days after the onset (short-term mortality ; 18%) and were compared with with those of patients that survived. Patients who died were significantly older than survivers (76 vs 68 years, p<0.01), were more likely to be women (50 vs 31%), to have had hypertension, diabetes mellitus, prior MI,or Killip class III or IV disease. Mortality as a result of heart failure, cardiac rupture, or arrhythmia fell exponentially after the onset. Reperfusion therapy was efficacious to reduce the early mortality.The site of organic coronary stenosis was resected by DCA catheter in patients with coronary artery spasm and chronic stable angina pectoris. The thickened intima was histologically examined, however, we were not able to define findings peculiar to the site of coronary spasm. Lipoprotein analysis was performed using an HPLC method in patients with ischemic heart disease. The data has been accumulating to define risks relating to the levels and size of lipoprotein fractions.Mechanism of the occurrence of ventricular fibrillation after reperfusion was studied in anesthetized open-chest dogs using 60 unipolar epicardial electrograms. In VF group, ST alternans progressed with time after reperfusion. Conduction block and reentry located between sites of discordant ST alternans ensued just before the appearance of VF.Rabbits showing hypertriglyceridemia were inbred from WHHL rabbits and the penetration rate of hypertriglyceridemia was 95% after 4 generations. Their pathophysiological features were analyzed in detail.

1993年4月至1995年12月，对山形县急性心肌梗塞（AMI）后早期死亡率及其影响因素进行了研究。在41家医院的1014例AMI患者中，184例患者在发病后28天内死亡（短期死亡率; 18%），并与存活患者进行比较。死亡的患者明显比存活者年长（76比68岁，p<0.01），更可能是女性（50比31%），患有高血压、糖尿病、既往MI或Killip III或IV级疾病。由于心力衰竭、心脏破裂或心律失常而导致的死亡率在发病后呈指数下降。对冠状动脉痉挛合并慢性稳定型心绞痛的患者，采用DCA导管切除器质性狭窄部位。对增厚的内膜进行了组织学检查，然而，我们无法确定冠状动脉痉挛部位特有的发现。采用高效液相色谱法对缺血性心脏病患者进行了脂蛋白分析。数据已经积累到定义的风险有关的水平和大小的脂蛋白fractions.Mechanism的发生再灌注后心室颤动的研究在麻醉开胸犬使用60单极心外膜电图。VF组再灌注后ST段电交替随时间延长而加重。室颤出现前，传导阻滞和折返出现在不一致的ST段交替之间。从WHHL兔中选育出高胆红素血症的家兔，4代后高胆红素血症的穿透率为95%。并对其病理生理特点进行了详细分析。

项目成果

Otomo, J, et al: "Roles of nitric oxide and adenosine in the regulation of coronary conductance in the basal state and during reactive hyperemia" Jpn Circ J. 61(5). 441-449 (1997)

Otomo, J 等人：“一氧化氮和腺苷在基础状态和反应性充血期间冠状动脉电导调节中的作用”Jpn Circ J. 61(5)。

Otomo J, et al: "Roles of nitric oxide and adenosine in the regulation of coronar conductance in the basal atate and during reactive hyperemia." Japanease Circulation Journal. 61(5). 441-449 (1997)

Otomo J 等人：“一氧化氮和腺苷在基础冠状动脉电导调节和反应性充血期间的作用。”

Fujiwara S, et al.: "Fatty acid metabolic imaging with iodine-123-BMIPP for the diagnosis of coronary artery disease." JNM. 38(2). 175-180 (1997)

Fujiwara S 等人：“利用 iodine-123-BMIPP 进行脂肪酸代谢成像，用于诊断冠状动脉疾病。”

Hirono O.et al.: "Impaired hyperemic response of forearm vessels in patients with coronary aartery disease." Japan Heart Journal. 37(6). 837-846 (1996)

Hirono O.等人：“冠状动脉疾病患者前臂血管充血反应受损。”

Kubota, I, et al.: "Early mortality after acute myocardial infarction:Observational study in Yamagata." Jpn Circulation J. (印刷中).

Kubota, I 等人：“急性心肌梗死后的早期死亡率：山形的观察性研究。”（正在出版）。