CORONARY VASCULAR TONE AFTER CORONARY BYPASS OPERATIONS

冠状动脉搭桥手术后的冠状血管张力

• 批准号: 3966639
• 负责人: R MARCH
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3966639
• 关键词: acidity /alkalinity; calcium channel blockers; cardiac output; coronary bypass; coronary disorder; creatine kinase; heart circulation; heart disorder chemotherapy; heart metabolism; heart output disorder; hemodynamics; human subject; lactate dehydrogenases; lactates; oxygen consumption; pyruvates; thermal blood flow measurement; vascular resistance

This clinical study tests the hypothesis that coronary blood flow dynamics of patients may be altered in the immediate interval after a coronary bypass procedure which may be deleterious to the patient's future course if unrecognized. A thermal dilution catheter is placed into the coronary sinus percutaneously and threaded to the great cardiac vein. Ports located at the tip allow sampling of the anterior myocardium and those more proximal sample the entire left ventricle. Blood samples are used to determine regional oxygen consumption, acid base balance, lactic acid, pyruvate, creatine kinase, and lactic dehydrogenase isoenzyme concentrations. Complete hemodynamic evaluations are performed preoperatively and in serial fashion for 6-8 hours after operation. Six patients have had complete studies. In some, no significant changes in coronary vascular resistance, cardiac output, or any of the biochemical variables occur. Other patients show changes which can be related to less than optimal contractility and systemic flow. Control of heart rate through atrial pacing and preload may eliminate some of this variability. Animal studies indicate that the use of a fiberoptic, thermodilution catheter will allow on-line documentation of myocardial metabolic trends. Such continuous measurement will allow better assessment of coronary flow dynamics in future patients studies.

本临床研究验证了冠状动脉血流动力学假说