Japanese

Left ventricular regional function and myocardial metabolic changes during ischemia Masaki Oguma 1 , Kai Tsuiki 1 , Tetsuji Kaminishi 1 , Shoji Yasui 1 1The First Department of Internal Medicine, Yamagata University School of Medicine pp.183-188
Published Date 1986/2/15
DOI https://doi.org/10.11477/mf.1404204823
  • Abstract
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The mechanisms for the abnormality of regional myocardial function during acute coronary artery occlusion still remain in dispute. We studied them from the viewpoint of myocardial metabolic changes.

In left ventricle of 28 open-chest, anesthetized dogs, four pairs of ultrasonic dimension gauges were implanted in ischemic and non-ischemic regions, and segment length (SL), wall thickness (WT) and their first time derivatives were measured. Left ventricular pressure (LVP), aortic pressure (AoP), pH in myocardium, and lactate concentration in ascending aorta and coronary sinus blood were also measured. ATP and lactate concentration in myo-cardium were measured for drill-biopsied specimen.

In ischemic region, left anterior descending coro-nary artery (LAD) occlusion resulted in increase of end-diastolic SL and decrease of end-diastolic WT, % systolic shortening, maximum velocity of systolic shortening (max dL/dt), % systolic thicken-ing, and maximum velocity of systolic thickening (max dW/dt). In non-ischemic region, however, increase of % systolic shortening, max dL/dt, systolic thickening, and max dW/dt were observed after LAD occlusion. LVP and AoP as indices of total LV function did not change. Increased lactate concentration in myocardium may be a main cause of decrease in pH in ischemic myocardium. ATP concentration in ischemic myocardium and lactate concentration in ascending aorta and coronary si-nus blood did not change in early stage of ischemia.

After LAD occlusion, ischemic myocardium be-came hypokinetic, while there was a hyperkinesis in non-ischemic myocardium. We suppose that the hypokinesis of ischemic myocardium results from de-crease in pH, and not from decrease of ATP con-centration, as far as early stage of ischemia is con-cerned.


Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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