体外心脏震波对急性心肌梗死模型猪左心室重塑的影响

背景:初期实验已经证实体外心脏震波治疗可从基因和细胞水平改善缺血心肌代谢,但是否在形态学水平也可缓解梗死后心室重塑的发展?目的:观察体外心脏震波对急性心肌梗死后左心室心功能及形态学指标的影响。方法:将25只猪随机分为3组:震波治疗组于制作心肌梗死模型后第3,5,7天,给予体外震波治疗,假震波组于制作心肌梗死模型后实施与震波治疗组相同的震波治疗操作,但不施以震波及能量,假手术组除了不造成心肌梗死,其余操作假震波组。结果与结论:与假震波组比较,震波治疗可明显缓解左室收缩末容积和舒张末容积扩大及改善左心室整体心功能(P<0.001),能显著改善心肌梗死交界区心肌局部室壁运动功能和左心室各节段运动协调性。说明及早有效的进行体外心脏震波治疗可在一定程度上延缓心肌梗死后左心室重塑由可逆阶段向不可逆阶段发展。

Effect of extracorporeal cardiac shock wave therapy on left ventricular remodeling in a porcine model of acute myocardial infarction

BACKGROUND:Initial studies have confirmed that extracorporeal cardiac shock wave therapy can ameliorate metabolism of ischemia myocardium from the level of gene and cells.However,will the therapy improve the development of post-infarction ventricular remodeling in a morphology level? OBJECTIVE:To explore the effects of extracorporeal cardiac shock wave therapy on the function and morphology of the left ventricle after acute myocardial infarction.METHODS:A total of 25 pigs were randomly divided into three groups:shock wave group,sham shock wave group and sham operation group.Pigs in the shock wave group were treated with extracorporeal cardiac shock wave therapy on 3,5 and 7 days after the model construction of myocardial infarction.Pigs in the sham shock wave group received the same therapy to the shock wave group except for the shock waves and energy.Sham operation group received the same treatment to the sham shock wave group without constructing the myocardial infarction model.RESULTS AND CONCLUSION:Compared with the sham shock wave group,shock wave therapy significantly reduced the left ventricular end-systolic volume,increased the end-diastolic volume and improved the global left ventricular function(P < 0.001);it significantly improved the ventricular wall motor function in the myocardium of the myocardial infarction border zone and the motion compatibleness of the left ventricular.These findings demonstrate that the early application of effective extracorporeal cardiac shock wave therapy can delay the development to some extent from reversible stage to irreversible stage in the left ventricular remodeling after myocardial infarction.