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

概要

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To clarify the mechanism why the myocardium at the epicardial rim can survive in transmural myocardial infarction, we measured regional myocardial blood flow (Qm) during coronary occlusion in 12 closed-chest dogs. The left anterior descending coronary artery was occluded by a balloon catheter and non-radioactive colored microspheres were injected into the left atrium before and after coronary occlusion. The occluded myocardium was removed and sliced at a thickness of 0.5mm from the epicardial surface to the endocardium. Qm measured 5sec after occlusion amounted 74.8±8.8%of control at the myocardium of 0.5mm in depth from the epicardial surface. At the myocardium with the depth of 10%of total thickness, Qm was 62.3±7.1%; at the depth of 10-20%, Qm was 32.9±9.4%; at 20-40%, 18.2±2.7%; at 40-60%, 11.2±2.3%; at 60-80%, 3.8±0.6%; at 80-100%, 5.2±1.8%. These indicated that Qm during occlusion was remarkably high at the epicardial thin layer. Preservation of high Qm during coronary occlusion might be the reason to maintain the epicardial rim viable at transmural myocardial infarction.
特定非営利活動法人日本バイオレオロジー学会の論文