家猪急性心肌梗塞模型冠脉零流量压与存活心肌的相关性

目的:探索制备的家猪急性心肌梗塞模型中梗塞相关冠状动脉零流量压(Pzf)与存活心肌面积的关系。方法:普通家猪13只,冠脉造影结束后应用指引导管测量前降支近端压力,置入冠脉内多普勒导丝测量前降支远端冠脉内的血流速度,绘制压力-血流速度坐标轴,计算Pzf。将球囊送至冠状动脉左前降支中远端,堵闭血流60～100min,建立心梗模型。模型建立后重复测算前降支Pzf,分析心梗模型制备前后前降支Pzf数值的变化。处死试验动物,切片心肌采用TTC染色法识别梗塞心肌与存活心肌,采用图像分析仪分析代表存活心肌的颜色占整个左心室面积的百分数,将其与梗塞后前降支Pzf数值联合建立坐标轴,观察二者之间的关系。结果:所有家猪均完成冠状动脉左前降支远端的封堵,2只家猪分别在堵闭45和65min时因心室纤颤死亡。存活11只家猪均成功地建立急性心肌梗塞模型,完成Pzf数值的测算。心梗后前降支的Pzf(53.06±23.01)mmHg]较心梗前(40.13±19.53)mmHg]显著升高,P0.001。线性回归分析显示,TTc染色存活心肌占左心室面积的百分数与测得的Pzf值呈负相关(r=-0.879,P0.001)。结论:运用经皮腔内冠状动脉成形术球囊封堵冠状动脉可成功建立猪急性心肌梗塞模型,存活心肌的面积与相关血管的零血流量压呈负相关,提示零流量压的测定可以作为预测心梗后存活心肌范围的一个指标。

Correlation between viable myocardium and zero flow pressure in swine model of acute myocardial infarction

Objective： To explore the relationship between the viable myocardium and zero flow pressure （Pzf） of coronary artery in swine model of acute myocardial infarction （AMI）. Methods： The 13 swines received coronary angiography, the pressure of coronary arteries were measured through guiding catheter and the distal flow velocity of left anterior descending coronary arteries measured through Doppler wire. Drawing the pressure-flow velocity coordinate graph, then calculated Pzf. Blocked up distal of left anterior descending coronary arteries by angioplasty balloon for 60- 100 min to establish the AMI model. The Pzf were repeated calculate. Analysis the Pzf difference between before and after the AMI model established. Taken out of those swines hearts after executed them, sliced the cardiac muscle to dye with TTC to detect the viable myocardium. The percent value of viable myocardium area were estimated by image tool 3.0. Drawing the percent value of viable myocardium-Pzf coordinate graph after the AMI model estahlished and observed relationship between them. Results： The 11 out of 13 swines were successfully established AMI models by coronary occlusion, 2 swines died of ventricular fibrillation after their coronaries were occluded 45 and 65 min respectively. The viable myocardium could be detected by using TTC dyeing. Compared with AMI before, the Pzf of left anterior descending coronary after AMI significantly increased （40.13 ± 19.53） mmltg vs. （53.06 ± 23.01） mmhg, P〈 0. 001]. Linear regression analysis show that the percent value of viable myocardium area were negative correlation with Pzf （r= -0. 879, P%0. 001）. Conclusion： The swine AMI model can be established successfully by coronary occlusion with angioplasty balloon. The percent value of viable myocardium area were negative correlation with Pzf, it indicate that Pzf is a index to predict the extent of viable myocardium after acute myocardial infarction.