Serial Transcardiac Lactate Metabolism in Post-reperfused Stunned Myocardium in Evolving Myocardial Infarction : 54th Annual Scientific Session of the Japanese Circulation Society
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概要
- 論文の詳細を見る
To elucidate the relationship between lactate metabolism following reperfusion and restoration of left ventricular (LV) function, we assessed serial changes in transcardiac lactate metabolism following reperfusion therapy in 67 patients admitted to hospital within 6 h of the onset of acute anteroseptal myocardial infarction. Left ventriculograms taken about 30 min after reperfusion therapy revealed marked dyskinesis in the anteroapical region in all subjects. According to the regional ejection fraction (rEF), determined 4 weeks later as an index of LV function, patients were divided into 3 group: 1) Restored LV group: 28 patients with reperfusion and restored LV function (rEF>30%); 2) Poor LV group: 26 patients with reperfusion but poor LV function (rEF<30%); 3) Failure group: 13 patients with failed reperfusion and occluded left anterior descending coronary artery. Although there was no difference in elapsed time and time to peak creatine phosphokinase (CPK) between the former 2 groups, the Restored LV group demonstrated lower peak CPK values, suggesting that these patients had less myocardial injury. Immediately after reperfusion, both groups showed transcardiac lactate production. In the Restored LV group, aerobic lactate metabolism was restored early after reperfusion (at 6 h), while in the Poor LV group prolonged anaerobic lactate metabolism was observed. These results suggest that an early restoration of aerobic metabolism might be a sign of stunned and viable myocardium, and a sustained lactate production might relate to a sustained process of myocardial injury.
- 社団法人日本循環器学会の論文
- 1991-09-20
著者
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KODAMA Kazuhisa
Cardiovascular Division, Osaka Police Hospital
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Hirayama Atsushi
Cardiovascular Division, Osaka Police Hospital
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Nakano Susumu
Department Of Advanced Cardiovascular Therapeutics Osaka University Graduate School Of Medicine
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Asada Shinji
Cardiac Intensive Care Unit of Osaka Police Hospital
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Asada Shinji
Cardiovascular Division Osaka Police Hospital
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Mishima Masayoshi
Cardiovascular Division Kawachi General Hospital
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Mishima Masayoshi
Cardiovascular Center Kawachi General Hospital
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Nanto Shinsuke
Cardiovascular Division
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Nanto Shinsuke
Cardiac Intensive Care Unit Of Osaka Police Hospital
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Hirayama Atsushi
Cardiovascular Division Osaka Police Hospital
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Asada Shiiji
Osaka Police Hospital
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Mishima Masayoshi
Osaka Acute Coronary Insufficiency Study (oacis) Group
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Kodama Kazuhisa
Cardiac Intensive Care Unit Of Osaka Police Hospital
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