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Title:: Effect of left ventricular assist on the form and structure in myocardial cell of canine with acute left ventricular failure

作者:: 贺涛; 易定华; 刘金成; 徐学增; 俞世强; 谭红梅; 第四军医大学西京医院心血管外科，陕西西安710032

Author(s):: HE Tao; YI Dinghua; LIU Jincheng; XU Xuezeng; YU Shiqiang; TAN Hongmei; Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China

关键词:: 心脏辅助装置; 心室功能障碍; 心肌; 组织形态学

Keywords:: left ventricular assist; left ventricular failure acute; myocardial cell; histomorphology

分类号:: R541.6

DOI:: -

文献标识码:: A

摘要:: 目的通过研究自制气动左心辅助泵对急性左室心力衰竭实验犬进行辅助后心肌组织形态和结构的变化，观察左心辅助对缺血心肌的保护作用。方法 20只实验犬随机分为3组：辅助组（n=9）、心衰组(n=9)和对照组（n=2）。辅助组：急性左室心力衰竭后行左心辅助循环；心衰组：心衰形成后不进行左心辅助；对照组：开胸后未行处理。于术后6 h将动物处死。观察比较各组犬血流动力学、脑钠肽(Btype natriuretic peptide,BNP)及心肌组织形态和结构的变化。结果 ①辅助组血流动力学在辅助开始后迅速恢复，而心衰组则持续恶化，在辅助6 h时两组平均动脉压、中心静脉压等指标有统计学显著性差异（P<0.05）。②心衰后360 min辅助组脑钠肽水平是(58±7) ng/L，而心衰组为(133±4) ng/L，两组有显著性差异(P<0.01)。③辅助组心肌结构无明显损伤；在心衰组发现心肌明显水肿、线粒体水肿等变性坏死现象。结论自制气动左心辅助泵能明显改善急性左室心力衰竭实验犬血流动力学，保护心肌组织形态和结构。

Abstract:: AIM To observe the protective effect of domestic pneumatic left ventricular assist pump on the form and structure in myocardial cell of canine with acute left ventricular failure. METHODS 27 adult healthy dogs were randomizedly divided into 3 groups: assistant group(n=9) underwent left ventricular assistance; heart failure control group (n=9) established heart failure without left ventricular assistance, and control group(n=2). Changes of homodynamic, BNP and the form and structure in myocardial cell were observed. RESULTS ①There was significant difference of MAP, CVP between assistant group and heart failure group（P<0.05）. ②BNP levels were (59±7) ng/L in assistant group and (133±4) ng/L in heart failure group at 360 minutes after the establishment of heart failure(P<0.01). ③the myocardial structure was not obviously injured in the assistant group, while obvious degeneration and necrosis were observed in the heart failure group, such as edema in myocardial tissue and mitochondria． CONCLUSION The domestic pneumatic left ventricular assist device could markedly improve the homodynamic of the canine with acute left ventricular failure, and protect the form and structure in myocardial cell.

参考文献/References

［1］ Rose EA, Gelijns AC, Moskowitz AJ, et al. Longterm mechanical left ventricular assistance for endstage heart failure［J］. N Engl J Med, 2001, 345(20):1435-1443.

［2］ Holman WL, Davies JE, Rayburn BK, et al. Treatment of endstage heart disease with outpatient ventricular assist devices［J］. Ann Thorac Surg, 2002, 73(5):1489-1493.

［3］ Thohon V, Stetson SJ, Nagueh SF, et al. Cellular and hemodynamics responses of failing myocardium to continuous flow mechanical circulatory support using the DeBakeyNoon left ventricular assist device: a comparative analysis with pulsatiletype devices［J］. J Heart Lung Transplant, 2005, 24(5):566-575.

［4］ Goldstein AH, Monreal G, Kambara A, et al. Partial support with a centrifugal left ventricular assist device reduces myocardial oxygen consumption in chronic, ischemic heart failure［J］. J Card Fail, 2005, 11(2):142-151.

［5］ Kambayashi Y, Nakao K, Kimura H.et al. Biological characterization of human brain natriuretic peptide (BNP)and rat BNP: specific actions of BNP［J］．Biochem Biophys Res Commun， 1990， 173(2)：599-605.

［6］ Mukoyama M, Nakao K, Hosoda K, et al. Brain natriuretic peptide as a novel hormone in humans. Evidence for an exquisite dual natriuretic peptide system， artial natriuretic peptide and brain natriuretic peptide［J］. J Clin Invest，1991，87(4)：1402-1412．

［7］ Magovern GJ Jr, Christlieb IY, Kao RL, et al. Recovery of the failing canine heart with biventricular support in a previously fatal experimental model［J］. J Thorac Cardiovasc Surg, 1987, 94(5):656-663.

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左心辅助对急性左室心力衰竭犬心肌组织形态和结构的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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