KTP激光心肌血运重建术对急性心肌梗死犬左室功能的影响

Effects of transmyocardial revascularization with KTP laser on cardiac function in canine acute infarcted myocardium

目的 研究KTP激光心肌血运重建术 (TMLR)对急性心肌梗死犬心脏功能的影响。方法 家犬 12只 ,随机分为TMLR组和对照组 ,每组 6只 ,结扎左前降支中段 ,造成急性心肌梗死模型 ,TMLR组在梗死区以KTP激光行TMLR。术后动物饲养 2～ 3个月 ,以超声心动图经体表检测左室射血分数 (EF)、搏出量 (SV)、心输出量 (CO)、室壁运动指数 (WMSI)作为左室收缩功能的指标 ,测量二尖瓣口Ve、Va及E/A作为左室舒张功能的指标 ,以局部室壁收缩增厚率 (△T % )和心肌运动速度 (S、E和A峰 )代表梗死局部心肌的功能。结果 超声心动图检查发现 ,反映动物心脏整体收缩功能和整体舒张功能的指标 ,两组之间比较差异均无显著性意义。而反映梗死区局部收缩和舒张功能的指标 ,TMLR组明显好于对照组 ,两组之间差异有显著性意义。结论 KTP激光TMLR对梗死局部心肌功能有改善作用 。

Objective To study the effects of transmyocardial revascularization(TMLR) with frequency double Nd:YAG(KTP)laser on cardiac function in canine acute infracted myocardium.Methods Left thoracotomy was performed in 12 adult mongrel dogs.The left anterior descending (LAD) artery was ligated to create the acute myocardial infarction model.TMLR was performed with KTP laser in the acute infarcted LAD zone in TMLR group ( n =6);and no treatment in control group ( n =6).The left ventricular ejection fraction(EF),wall motion score index(WMSI),cardiac output(CO),the systolic and diastolic motion velocity of the anterior wall,the mitral flow velocity (Ve,Va)and the ratio of Ve and Va were assessed by transthoracic echocardiography in 2～3 months post treatment. Results After 2～3 months,there were no statistical differences in global systolic function and diastolic function between two groups,whereas the regional systolic and diastolic functions were significantly better in the TMLR group than those in control group.Conclusion TMLR with frequency double Nd:YAG laser might improve the regional function of infarcted area but did not improve the global cardiac systolic and diastolic functions in acute infarcted myocardium. [