<原著>冠動脈閉塞領域における局所心筋血流量と心筋壊死との関係
スポンサーリンク
概要
- 論文の詳細を見る
Regional myocardial blood flow (RMBF) developing soon after myocardial infarction may minimize myocardial necrosis. To test this hypothesis, RMBF to the area of acutely occluded coronary artery was determined successively over 4 weeks in 11 open-chest dogs. Non-radioactive colored microspheres were injected into the left atrium before occlusion of the left anterior descending coronary artery, and RMBF was measured at 5 seconds, 3 hours and 12 hours after occlusion. The chest was closed and then re-opened 4 weeks later. Microspheres were injected again into the left atrium and the heart was removed to measure RMBF and determine 3 indices of myocardial necrosis : myocardial creatine kinase activity (CK), infarct size as determined by triphenyl tetrazolium chloride stain (TTC), and Azan-Mallory stain for visualization of myocardial fibrosis. RMBF measured 5 seconds after occlusion (Q1), 3 hours (Q2), 12 hours (Q3) and 4 weeks later (Q4) was 27±3%, 26±3%, 29±3% and 35±3% of control at the inner layer, respectively. While at the outer layer, RMBF was 36±3,53±4,50±4 and 80±7Z%, respectively. These showed that both Q1 and the flow increase over the 4 weeks (Q4-Q1) were greater at the outer layer than the inner layer. The middle layer showed RMBF between those of the inner and outer layers. The inner layer showed a small flow increase between Q3 and Q4 (Q4-Q3=6±3%). At the outer layer, there were conspicuous flow increases during Q1 to Q2 (17±3%) and Q3 to Q4 (37±6%). The middle layer showed increases between those of the inner and outer layers. No consistent flow change was seen between Q2 and Q3 at any of the three layers. Q1 showed good correlation with 3 indices of myocardial necrosis. Since Q1 was measured 5 seconds after occlusion, this good correlation indicated that the rich pre-existing collaterals are important in minimizing myocardial necrosis Flow increases developing within 3 hours after occlusion (Q3-Q1) also showed good correlations with the 3 indices, while that increasing after 12 hours (Q4-Q3) showed an inconsistent relation with those indices. This study demonstrated that there was a considerable flow increase until 3 hours after coronary occlusion and this flow increase may contribute to reducing myocardial necrosis.
- 近畿大学の論文
- 1993-09-25
著者
関連論文
- 4.肺動脈楔入圧上昇を伴わず著明な肺うっ血像を呈し発症20日目に心破裂死した後下壁心筋梗塞の1例
- 0940 陳旧性心筋梗塞の長期予後においてCa拮抗剤とβ遮断剤のどちらが有用か?
- 154)心室中隔穿孔を来たす前壁梗塞の心電図上の特徴(日本循環器学会第77回近畿地方会)
- 111)陳旧性心筋梗塞の血圧値と心事故発生率の関係について(日本循環器学会第77回近畿地方会)
- 1289 心筋梗塞後の待機的PTCAの心事故防止効果
- 心筋梗塞犬におけるlate reperfusionの心筋salvageに及ぼす影響 : 日本循環器学会第74回近畿地方会
- カルシウム拮抗剤が心筋梗塞再発予防に及ぼす影響 : 日本循環器学会第74回近畿地方会
- 抗不整脈薬の心筋梗塞発症後の死亡率に及ぼす影響 : 第58回日本循環器学会学術集会
- 心筋梗塞後の心事故におよぼすβ遮断剤の効果 : 第58回日本循環器学会学術集会
- 冠動脈閉塞領域における局所心筋血流量と心筋壊死との関係
- Ca拮抗剤は陳旧性心筋梗塞の再発予防に有用か? : 第58回日本循環器学会学術集会
- 高血圧を合併した心筋梗塞におけるCa拮抗剤の再発に及ぼす影響について
- 陳旧性心筋梗塞患者における再梗塞発症率と血圧値の関係について : 日本循環器学会第72回近畿地方会
- 心筋梗塞後に狭心症を伴う例での抗血小板剤の再梗塞予防効果 : ポスター発表 : 第57回日本循環器学会学術集会
- カルシウム拮抗剤の再梗塞発症率に及ぼす影響 : 口述発表 : 第57回日本循環器学会学術集会
- 心筋外層における冠副血行発達の特異性と心筋壊死との関係 : ポスター発表 : 第57回日本循環器学会学術集会
- 冠再潅流におけるlate reperfusionが心外膜側心筋の salvageに及ぼす効果 : ポスター発表 : 第57回日本循環器学会学術集会
- 各種薬効別薬剤の心筋梗塞2次予防効果
- 23.経皮的経静脈的僧帽弁交連裂開術(PTMC)3例の経験
- 心筋梗塞再発予防の立場からみた至適血圧値について
- 陳旧性心筋梗塞患者の血圧値と再梗塞発症率
- 心外膜直下筋層epicardial rimにおける冠閉塞時の局所心筋血流分布の特殊性