| Japanese |
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| Title | 心筋虚血領域に与えるイソフルレンの影響 -熱画像法による解析- |
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| Subtitle | 原著 |
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| Authors | 石川岳彦* |
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| Organization | *北海道大学医学部麻酔学講座 |
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| Journal | 循環制御 |
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| Volume | 13 |
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| Number | 1 |
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| Page | 113-124 |
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| Year/Month | 1992/ |
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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」イヌの実験的心筋梗塞モデルにおいて, 心筋虚血領域は熱画像上, 心筋温低下領域として捕えられることを利用し, 揮発性吸入麻酔薬であるイソフルレンの心筋虚血におよぼす影響を検討した. イソフルレン麻酔により, 熱画像上の心筋虚血領域は血圧低下と共に用量依存性に拡大した. 熱画像上に捕えられた温度低下領域は, 組織病理学的検索による虚血性変化の範囲と良く一致していた. 同時に超小型水素イオン濃度測定プローブを心外膜下に刺入した結果でも, 温度低下領域と心筋虚血に伴う心筋水素イオン濃度上昇は一致し, 熱画像法による心筋虚血領域の評価は心筋虚血の研究法として有用であると考えられた. また, イソフルレン麻酔によって拡大した心筋虚血領域は, 交換神経α1受容体作動薬であるフェニレフリンの投与による動脈血圧の上昇と共に縮小した. イソフルレン麻酔による心筋虚血領域の拡大は, 動脈血圧維持により防止できると考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Isoflurane, Themography, Myocardial Ischemia |
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| English |
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| Title | Effects of Isoflurane on Myocardial Ischemic Area -A Thermographic Study- |
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| Subtitle | |
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| Authors | Takehiko Ishikawa |
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| Organization | Department of Anesthesiology Hokkaido University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 13 |
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| Number | 1 |
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| Page | 113-124 |
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| Year/Month | 1992/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | It is still controversial if isoflurane produces a coronary steal and deteriorates acute myocardial ischemia. The author evaluate the effects of isofiurane on myocardial ischemia in an expermental model of acute myocardial ischemia (AMI), using a thermographic imaging system. Twenty-five mongrel dogs were anesthetized with isoflurane. A left thoracotomy was performed and a small branch of the left coronary artery (LAD) was dissected free from the surrounding tissue. AMI was produced by clamping the exposed section of LAD. Thermal images of the myocardium were recorded at a rate of 30 images per second. Each image was analyzed on an engineering work station, and a colder spot of the myocardium resulting from clamping was defined as a Thermographically Determined Myocardial Ischemic Area (TDMIA). After the surgical preparation, the size of TDMIA by 1 MAC isoflurane was served as control (100%). Then, changes of TDMIA, myocardial pH and hemodynamic variables at 0.5, 1.0, 1.5, 2.0 and 2.5 MAC of isoflurane were evaluated. After the experiment, histopathological changes of ischemic myocardium around TDMIA wer also examined. Well-defined TDMIAs were obtained in all dogs after LAD clamping. TDMIA decreased to 66.7±30.7% (Mean±SD) of the control value by 0.5 MAC isoflurane, whereas it increased to 219±43.7% of the control value by 2.0 MAC isoflurane, lntravenous phenylephrine administration (2 μg/kg) at 2.0 MAC isoflurane increased arterial blood pressure and shrank TDMIA to the control level. Myocardial pH at the center of TDMIA decreased from 7.10±0.05 to 6.87±0.09 after LAD clamping and remained unchanged throughot the study, whereas myocardial pH at the limb of TDMIA changed according to the size of TDMIA. Histophathological findings revealed a transmural degeneration of cells which was coincident with TDMIAs. TDMIA analysis can demonstrate real-time changes of AMI in beating heart quantitatively and continuously. The results indicate that isoflurane may deteriorate AMI dose-dependently unless hemodynamics are maintained. |
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| Practice | Basic medicine |
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| Keywords | Isoflurane, Themography, Myocardial Ischemia |
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