Hemodynamic Mechanisms of Dynamic Cardiomyoplasty

动态心肌成形术的血流动力学机制

• 批准号: 08671541
• 负责人: MISAWA Yoshio
• 金额: $ 1.41万
• 依托单位: JICHI MEDICAL SCHOOL
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671541/
• 关键词: dynamic cardiomyoplasty; dilated cardiomyopathy; heart failure model; latissimus dorsi muscle; Cardiomyoplasty; rapid pacing; 補助循環

1. Six dogs were rapidly paced for 4 weeks with a VVI pacemaker, and observed for 4 to 6 weeks after cessation of rapid pacing. Echocardiographic study revealed congestive heart failure at the end of the rapid pacing associated with enlarged left ventricles and reduced left ventricular ejection fraction. Four weeks after cessation of the pacing, the left ventricular cavity and ejection fraction improved, but did not returned to the normal pre-paced values. Six weeks after the cessation, cardiac function fully recovered, and pathological study of the resected hearts demonstrated normal myocardium without fibrotic or ischemic changes.2. Six young beagles of 3 months underwent akinetic cardiomyopasty. The wrapped latissimus dorsi muscle flaps were growing and the left ventricular diastolic function was not impaired six to 12 months after wrapping. Pathological examination revealed slight to moderate fibrosis and fat infiltration, and a lot of intact muscle fibers. This idicates a potentially safe clinical application of dynamic cardiomyoplasty for children.3. We correlated the pathological findings with their clinical course in five patients who died 1 months to 6 years after dynamic cardiomyoplasty operation. It is indicated that the integrity of the latissimus dorsi muscle graft used to wrap the heart may affect the clinical outcome of patients undergoing dynamic cardiomyoplasty.

1. 6只犬用VVI起搏器快速起搏4周，停止快速起搏后观察4 ~ 6周。超声心动图检查显示快速起搏结束时充血性心力衰竭，与左心室扩大和左心室射血分数降低相关。起搏停止4周后，左心室腔和射血分数有所改善，但未恢复至正常起搏前值。停药后6周，心功能完全恢复，病理检查示心肌正常，无纤维化和缺血性改变. 6只3个月大的幼犬进行了无运动性心肌病。术后6 ~ 12个月，背阔肌瓣生长良好，左室舒张功能无明显损害。病理检查示轻至中度纤维化和脂肪浸润，并有大量完整的肌纤维。这表明儿童动力性心肌成形术具有潜在的安全性。我们对5例动力性心肌成形术后1个月至6年死亡的患者的病理结果与其临床病程进行了相关分析。结果表明，背阔肌移植物包裹心脏的完整性可能会影响动力性心肌成形术患者的临床结局。

项目成果

三澤吉雄: "Cardomyoplastyにおける被覆広背筋の組織変化" 骨格筋の心臓への応用研究会雑誌. 9. 3-5 (1998)

Yoshio Misawa：“心肌成形术期间背阔肌的组织变化”《心脏骨骼肌应用研究组杂志》，9. 3-5 (1998)。

三澤 吉雄: "心室のrapid pacingによる心不全モデルの自然経過と心筋の組織変化"日本胸部外科学会雑誌. 45. 42-45 (1997)

Yoshio Misawa：“心力衰竭模型的自然史和心室快速起搏引起的心肌组织变化”日本胸外科杂志 45. 42-45 (1997)。

三澤吉雄: "Cardiomyoplastyにおける被覆広背筋の組織変化" 第9回骨格筋の心臓への応用研究会雑誌. (印刷中).

Yoshio Misawa：“心肌成形术期间背阔肌的组织变化”第九届骨骼肌心脏应用研究组杂志（出版中）。

三澤吉雄: "Cardiomyoplastyにおける被覆広背筋の成長" 第8回骨格筋の心臓への応用研究会雑誌. (印刷中).

Yoshio Misawa：“心肌成形术中覆盖的背阔肌的生长”第八届骨骼肌心脏应用研究组杂志（正在出版）。

Wilson JR,Douglas P,Hickey WF,Lanoce V,Ferraro N,Muhammad A,Reichek N.: "Experimental congestive heart failure produced by rapid ventricular pacing in the dog : cardiac effects." Circulation. 75. 857-867 (1987)

Wilson JR、Douglas P、Hickey WF、Lanoce V、Ferraro N、Muhammad A、Reichek N.：“狗快速心室起搏产生的实验性充血性心力衰竭：心脏效应。”