<原著>冠動脈閉塞再開通後の左室心筋動態に関する実験的研究

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概要

• 論文の詳細を見る

• Coronary artery reperfusion using thrombolytic agents has been applied to myocardial salvage of acute myocardial infarction, but the effects of reperfusion on the evolving myocardial infarction have not been fully evaluated. In this study, the left anterior descending coronary arteries of 22 anesthetized open-chest dogs were dissected to occlude. The ultrasonic dimension systems were implanted to the myocardium perfused by the artery to measure the wall thickness. The coronary artery was ligated by silk suture for 3 hours. After that, the suture was removed to make reperfusion while the changes of wall thickness were being measured. Twelve of the 22 dogs were killed 2 hours after reperfusion and the others were killed 2 to 7 days afterwards. The wall thickness measured at the peak of R-wave of ECG was increased to 111.0±2.2% (SE) of the control immediately after reperfusion, one hour later. This increase was transient and the value subsequently returned near the controls (105.4±4.0%) at 6 hours after reperfusion. The myocardial reactive hyperemia may be a contributory mechanism to cause this initial transient increase. After this reduction of the transient increase, the wall thickness increased again gradually, making the second peak value of 123.6±2.7%, 4 days after reperfusion. Myocardial edema may be responsible to the gradual second increase. The myocardial water content was increased in the ischemic zone to 79.9±0.3% compared with 76.0±0.7% of that in the non-ischemic zone (p<0.001), suggesting the occurrence of myocardial edema. A marked myocardial hemorrhage macroscopically evaluated was present in all the dogs sacrificed 2 hours after reperfusion, while in the dogs sacrificed 7 days after, the hemorrhage was found of less marked degree in 4 out of 5 dogs. Despite of hemorrhage and myocardial edema found in reperfused myocardium, the systolic wall thickening was improved from the value observed immediately after reperfusion, 4.5±1.2%, to 15.4±6.9% 7 days after, which indicates that coronary reperfusion after 3 hour occlusion was effective to preserve myocardial function.

• 近畿大学の論文
• 1987-03-25

著者

• 門脇 宏之

  近畿大学医学部第一内科学教室

• 門脇 宏之

  近畿大学医学部第1内科学教室

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• 冠動脈閉塞再開通後の左室心筋動態に関する実験的研究

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