THE IMPORTANCE OF GOOD ENDOCARDIAL REFLOW IMMEDIATELY AFTER REPERFUSION FOR MYOCARDIAL SALVAGE IN DOGS

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We studied the importance of reflow after reperfusion for myocardial salvage. In 19 open-chest dogs, the left anterior descending coronary artery was occluded for 3h and then reperfused. Non-radioactive colored microspheres were injected into the left atrium to measure regional myocardial blood flow (RMBF). Immediately after occlusion. RMBF was reduced to 23±2% (of control) in the inner layer and 32±2% in the outer layer. Five minutes after reperfusion. RMBF was increased to 170±20% and 156±11% of control in the inner and outer layers, respectively. One week later. RMBF in the inner layer was reduced to 63±4% but it was not reduced (100±6%) in the outer layer. There was a roughly positive correlation between the inner/outer flow ratio measured 5 min after reperfusion and myocardial creatine kinase activity. Myocardial necrosis determined by triphenyl tetrazolium chloride stain varied inversely with the inner/outer flow ratio. These results indicate that good reflow in the inner layer 5 min after reperfusion is a favorable indicator for myocardial salvage.
社団法人日本循環器学会の論文
1991-10-20