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Evaluation of Cardiac Function of Left Ventricule Remodeling Surgery for Dilated Cardiomyopathy

扩张型心肌病左心室重构手术的心功能评价

基本信息

批准号：
11671338
负责人：
MISAWA Yoshio
金额：
$ 2.05万
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：
1999
资助国家：
日本
起止时间：
1999 至 2002
项目状态：
已结题

项目摘要

Experimental studies using dogs have not yet reached their final stages, because each dog needs 6 months at least for observation after surgery. We need additional studies to get definite conclusions. However, we have now preliminary results showing that skeletal muscle grafts wrapped around the heart tend to get fatigue resistance after several months.In clinical studies, we have revealed that mitral valve plasty is preferable to mitral valve replacement on the point of post-operative remodeling of the left ventricle in patients with degenerative mitral valve regurgitation, and that patients undergoing aortic valve replacement with stentless prosthetic valve can regain left ventricular remodeling in the early post-operative phase. As our other experiences, we have discussed intractable issues of myocardial infarction occurring after Batista operation in an international journal, and we have reported initial clinical results of maze procedure in consecutive 12 patients undergoing concomitant mitral valve surgery, showing that electro-physiological remodeling was obtained in 11 patients in the early post-operative phase up to 17 months.Through Correspondence at Letters to the Editor in international scientific journals, we have been discussing mechanisms of hemodynamic assists after cardiomyoplasty. During the term of this project, our subjects includes the girdling effect and sparing effect, which are recognized even in adynamic cardiomyoplasty and the reduction of myocardial oxygen consumption after dynamic cardiomyoplasty. In addition, we insist on serial assessment is inevitable when left ventricular remodeling is evaluated after valve replacement in patients with aortic regurgitation. We have already reported that serial assessment alone can lead reliable results over issues of left ventricular remodeling in patients with left ventricular volume over-loading valve diseases.

使用狗进行的实验研究尚未进入最后阶段，因为每只狗在手术后至少需要6个月的观察。我们需要更多的研究才能得出明确的结论。然而，我们现在有初步的结果表明，骨骼肌移植物包裹在心脏周围，几个月后往往会获得抗疲劳性。在临床研究中，我们已经发现，二尖瓣成形术优于二尖瓣置换术，在退行性二尖瓣反流患者的术后左心室重塑方面，无支架人工主动脉瓣置换术患者术后早期可恢复左室重构。作为我们的其他经验，我们在一份国际期刊上讨论了巴蒂斯塔手术后发生的心肌梗死的棘手问题，我们报告了迷宫手术在连续12例同时接受二尖瓣手术的患者中的初步临床结果，显示11例患者在术后早期获得了电生理重构，手术期长达17个月。通过国际科学期刊上的编辑信件，我们一直在讨论心肌成形术后血流动力学辅助的机制。在本课题研究期间，我们的研究课题包括：即使在贴壁心肌成形术中也存在的环缩效应和保留效应，以及动力性心肌成形术后心肌耗氧量的减少。此外，我们认为，在评价主动脉瓣反流患者瓣膜置换术后左心室重构时，系列评价是不可避免的。我们已经报道了单独的系列评估可以在左心室容量超负荷瓣膜疾病患者的左心室重构问题上获得可靠的结果。