| Japanese |
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| Title | 開心術後症例におけるGlucagonの冠循環および心筋代謝に及ぼす影響 |
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| Subtitle | |
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| Authors | 若松正樹*, 山本道雄*, 田中一彦**, 公文啓二**, 林研二***, 川副浩平***, 鬼頭義次***, 藤田毅*** |
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| Authors(kana) | |
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| Organization | *岐阜大学医学部麻酔科, **国立循環器病センターICU, ***国立循環器病センター心臓外科 |
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| Journal | 循環制御 |
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| Volume | 4 |
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| Number | 2 |
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| Page | 327-335 |
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| Year/Month | 1983/ |
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| Article | 原著 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | 「要旨」開心術後症例にglucagonを0.5μg/kg/minで1時間投与し, 循環動態(5例)および心筋代謝(4例)への影響について検討した. 循環系に対してはmildな陽性変力作用が認められ, 心係数の増加傾向(投与開始後1時間値:15.3%)および体血管抵抗の減少傾向(-19.2%)を示した. しかしその際, 冠血管抵抗は減少傾向(-24.7%)を示したが心筋酸素摂取率はあまり変化せず, glucagonによる冠状静脈洞血流量の増加(23.1%)は心筋酸素消費量の増大(20.3%)に見合うだけのもので, 冠血管は2次的に拡張したにすぎないと考えられた. 一方, 個々の症例では心機能の変化をある程度は心筋代謝からも裏付けられたが, 全体的には代謝面ではとくに一定した変化が得られず, glucagonの心筋代謝への影響についてはさらに検討が必要と考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Effects of glucagon on coronary circulation and myocardial metabolism after open heart surgery |
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| Subtitle | |
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| Authors | Masaki WAKAMATSU*, Michio YAMAMOTO*, Kazuhiko TANAKA**, Keiji KUMON**, Kenji HAYASHI***, Yoshitugu KITO***, Kohei KAWAZOE***, Tsuyoshi FUJITA*** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, Gifu University School of Medicine, **Department of Intensive Care Unit, National Cardiovascular Center, ***Department of Cardiac Surgery, National Cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 4 |
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| Number | 2 |
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| Page | 327-335 |
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| Year/Month | 1983/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Glucagon were administered 0.5 μg/kg/min intravenously for 60 minutes period to patients immediately after open heart surgery. In 5 patients, glucagon produced a 23% increase in coronary sinus blood flow, a 20% increase in myocardial oxygen consumption and a 25 % decrease in coronary vascular resistance at the end of infusion. Only slight change of myocardial oxygen extraction suggests that the increase in blood flow is sufficient to meet the increased myocardial oxygen demands induced by glucagon. In 4 patients, examinations were made on the myocardial extraction and usage of lactate, pyruvate, glucose and free fatty acid after glucagon administration. Glucagon produced a 222% increase in arterial insulin concentration at the end of infusion, but this was not always followed by a clinical improvement in myocardial function and metabolism. In addition, glucagon showed a mild inotropic action and produced a 15% increase in cardiac index at the end of infusion. In conclusion, our results indicate that glucagon is a moderately effective agent to augment cardiac function after open heart surgery but its effect on myocardial metabolism needs further careful clinical observation. |
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| Practice | Basic medicine |
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| Keywords | glucagon, coronary sinus blood flow, coronary circulation, myocardial metaboiism |
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