| Japanese |
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| Title | 冠動脈狭窄域の心筋酸素需給関係に及ぼす陽性変力薬の影響 -心拍数増加時における比較- |
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| Subtitle | 原著 |
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| Authors | 藤垣徹*, 緒方良治*, 後藤慎一**, 深野拓**, 長谷場純敬**, 後藤裕** |
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| Authors(kana) | |
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| Organization | *長崎大学医学部集中治療部, **長崎大学医学部麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 10 |
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| Number | 3 |
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| Page | 439-448 |
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| Year/Month | 1989/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」ペントバルビタール麻酔下冠動脈狭窄犬に, ドパミン(DA), ドブタミン(DB), アムリノン(AM), ミルリノン(MI)の四種類の陽性変力薬をそれぞれLVdp/dtmaxが30%増加するように投与して, 狭窄域の心筋酸素分圧(PmO2)を測定し, その中から各群ともにHRが10 beats/min以上増加した症例のみを選び, ある程度の変時作用が生じた状態での各薬剤の比較を行なった. その結果, 狭窄域の心筋酸素需給関係を反映すると考えられるPmO2はDB, MIでは不変であったが, DAでは-4.0mmHg, AMでは-6.1mmHgの有意な減少を示し, 同時に心筋乳酸摂取率はAMでは-7.0%の有意な減少, DAは有意ではないが-11%の変化を示し, DAとAMでは心筋虚血が生じたことが示唆された. 以上の結果の原因としては, DBは血圧上昇による灌流圧の増加によって心筋酸素需給関係が保たれた可能性が考えられる. 一方, AMは灌流圧の減少と著明な冠拡張作用による血流のmaldistributionによって, またDAは冠血管収縮作用によって心筋虚血が生じた可能性が考えられる. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Heart, coronary blood flow, myocardial ischemia, Inotropics, dopamine, dobutamine, amrinone, milrinone |
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| English |
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| Title | The Effects of Inotropic Agents on Myocardial Oxygen Balance in The Dogs with Coronary Artery Stenosis |
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| Subtitle | |
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| Authors | Toru Fujigaki*, Ryoji Ogata*, Sinichi Gotoh**, Taku Fukano**, Sumitaka Haseba**, Yutaka Gotoh** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology Nagasaki University, **Faculty of Medicine Nagasaki University |
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| Journal | Circulation Control |
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| Volume | 10 |
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| Number | 3 |
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| Page | 439-448 |
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| Year/Month | 1989/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Dopamine, dobutamine, amrinone and milrinone were administered to dogs with coronary artery stenosis under pentobarbital anesthesia. The myocardial oxygen tension (PmO2) was measured in cases in which the heart rate increased to 10 beats/min or more during administration. As a result, PmO2, which is thought to reflect the relationship between myocardial oxygen demand-supply, showed no change for dobutamine and milrinone but a significant decrease of -4.0 mmHg and -6.1 mmHg for dopamine and amrinone, respectively. The myocardial lactate extraction ratio showed a significant decrease of -7.0% for amrincne and, although not significant, a change of -11% for dopamine, thereby indicating that myocardial ischemia occurred under administration of amrinone and dopamine. The causes behind these findings are considered as follows. With dobutamine, it is thought that the myocardial oxygen balance was maintained by an increase in perfusion pressure. With amrinone and dopamine, on the other hand, it is possible that the myocardial oxygen balance was lost by a maldistribution of coronary blood flow due to strong vasodilating action and by a decrease of perfusion pressure in the case of amrinone, and by coronary vasoconstricting action in the case of dopamine. |
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| Practice | Basic medicine |
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| Keywords | Heart, coronary blood flow, myocardial ischemia, Inotropics, dopamine, dobutamine, amrinone, milrinone |
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