Hemodynamics and Endothelial Function of Perioperative Myocardial Ischemia
| Project/Area Number |
09671594
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Section | 一般 |
|---|
| Research Field |
Anesthesiology/Resuscitation studies
|
|---|
| Research Institution | Kurume University School of Medicine |
|---|
Principal Investigator |
WATANABE Seiji Kurume University School of Medicine, Lecturer, 医学部, 講師 (10201196)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
KANO Tatsuhiko Kurume University School of Medicine, Lecturer, 医学部, 教授 (50040605)
YAMADA Shinichi Kurume University School of Medicine, Lecturer, 医学部, 助手 (90258484)
HAMADA Nobuya Kurume University School of Medicine, Lecturer, 医学部, 助手 (70238070)
|
|---|
| Project Period (FY) |
1997 – 1998
|
| Project Status |
Completed (Fiscal Year 1998)
|
| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 1998: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1997: ¥2,900,000 (Direct Cost: ¥2,900,000)
|
|---|
| Keywords | Coronary spasm / Myocardial ischemia / parasympathetic nerve / Endothelial function / Endothelin-1 / Acethylcholine stress test / 副交感神経 / 血管内皮機能 / 一酸化窒素 |
|---|
| Research Abstract |
To determine whether the stimulation of parasymapthetic nerve could evoke the coroanry constriction, we conducted two studies including the intracoronary acetylcholine stress test in dogs and the edrohpnium stress test in patients with ischemic heart disease.
1)Animal experiment : To investigate that the coronary vascular tone possibly modulate the response of intracoronary acethylcholine (Ach) injection. Methods : 6 successful experiments were accomplished in 10 dogs. Dogs were anesthetized with thiopental (5mg/kg) and morphine (3mg/kg) and maintained with inhalation of sevoflurane. Coronary shunt from carotid artery to LAD was installed. EM flow probe was incorporated and measured the toal coronary flow to LAD.HR was controlled by ventricula pacing after the accomplishion fo AV block (123 bpm). Blood pressure maintaine with the pressurized blood reservor (84mmHg). The graded doses of intracoronary Ach (0.01-1Omicrog) injected through this cannula. LAD flow arid coronary perfusion pres
… More
sure were monitored following the Ach injection. Intracoronary endotheline-t (ET-1) was infused to redue 30% of co ronary flow fromthe baseline value. Ach stress test was repeated before and after introcoronary in fusion of ET-1. Results : LAD flow increased with intracoronary Ach indose dependent. mannaer.ET-1 inhibited LAD flow response to Ach. LAD flow decreased below contorl value at the recoveryphase after reactive hyperemia to Ach with ET-1, but not without ET-1. Conclusion : High coronary vascular tone possibly need to induce the coronary constriction with the activation of parasympathetic nerve.
2)Clinical study : To study whether the activation of parasympathetic nerve induce myocardial ischemia due to the coronary spasm. Material and methods : We studied 15 patients with coronary artery disease scheduled for elective coronary artery surgery (CABG). A bolus dose of Edr (0.25mg・kg-1) was injected through a central venous catheterl during harvesting of left internal thoracic artery. Edr successfully induced sinus bradycardia in all patients. Heart rate (HR) reached the maximum reduction at 3 minutes (-15.3*6.8 beat・smin-1, p<O.O1). The maximum reduction of HR was proportionally amplified with an increasing baseline HR (r=-0.80, p<O.001). Systemic and pulmonary arterial pressures did not change during this period. Prolongation of PQ duration appeared on lead II EGG for 1 minute after Edr injection (p<O.0 1). No new deviation of ST segments was observed on leads II or V5 for 20 minutes. Conclusion : Only the activation of parasympathetic nerve less possibly induce coronary spasm in the patients with ischemic heart disease. Less
|
Report
(3 results)
Research Products
(3 results)
