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Transmyocardial revascularization aggravates myocardial ischemia around the channels in the immediate phase
Ist Teil von
American journal of physiology. Heart and circulatory physiology, 2000-09, Vol.279 (3), p.H1392-H1396
Ort / Verlag
United States
Erscheinungsjahr
2000
Quelle
MEDLINE
Beschreibungen/Notizen
1 Departments of Physiology, 2 Cardiology,
3 Surgery, and 4 Research Center for
Genetic Engineering and Cell Transplantation, Tokai University School
of Medicine, Isehara 259-1193; 5 School of
Medicine, Keio University, Tokyo 160-8582;
6 Shohnan Kamakura Hospital, Kamakura 247-8533; and
7 High Energy Accelerator Research Organization, Tsukuba
305-0801, Japan
We examined whether
transmyocardial revascularization (TMR) relieves myocardial
ischemia by increasing regional perfusion via the transmural channels
in acute canine experiments. Regional blood flow during transient
coronary ligation (2 min) was compared before and 30 min after TMR, and
at the third transient ischemia the mid-left ventricle (LV) was cut and
immediately frozen along the short axis for the analysis of NADH
fluorescence in the regions around the TMR channels. In low-resolution
analysis (2-4 g tissue or 2-3 cm 2 area), regional
perfusion was not significantly altered after TMR, and NADH
fluorescence was observed throughout the ischemic region without
significant spatial variation. High-resolution analysis (2.8 mg, 1 mm × 1 mm) revealed that the flow after TMR was lower, and NADH
fluorescence was higher in the regions close to the channels (1-2
mm) than in the regions 3-4 mm away from them. Creating TMR
channels did not improve the regional perfusion and rather aggravated
the local ischemia in the vicinity of the channels in the immediate phase.
regional blood flow; microspheres; NADH fluorescence