关键词: 缺血性心脏病, 激光心肌血管重建术, 碱性成纤维生长因子, 心肌存活性, 心室功能, 超声心动描记术

Abstract: AIM: To assess the effects of transmyocardial laser revascularization (TMLR) combined with basic fibroblast growth factor-fibrin glue (bFGF-FG) on the myocardial viability and the cardiac regional and global function in dog models with acute myocardial ischemia (AMI). METHODS: Eighteen crossbred dogs were randomized to three groups.(AMI, TMLR and bFGF-FG groups).The occlusion of the left anterior descending artery (LAD) of all animals was created in order to develop acute ischemic myocardium models.TMLR procedure was carried out 30minutes after coronary ligation in both TMLR and bFGF-FG groups, and afterward bFGF-FG was planted in laser channels in bFGF-FG group.15 dogs underwent conventional and pulsed Doppler tissue imaging dobutamine stress echocardiography two months after LAD occlusion (other 3 dogs for each group died 42, 56 and 60 days after operation, respectively). RESULTS: There was no difference in the diameter of left atrium and ventricle among three groups (P >0.05).The regional and globe function parameters of the left ventricle improved in the TMLR and bFGF-FG groups gradually by turns, compared to the AMI group, of which there were significant differences in some variables among three groups (P <0.05 or P <0.01).In AMI group, the parameters above worsened during dobutamine infusion, of which some changed significantly (P <0.05 or P < 0.01).In TMLR group, the parameters improved during dobutamine infusion in 5 μg·kg ^-1·min ^-1, of which some changed significantly (P <0.05 or P <0.01), while they changed in reverse direction during dobutamine infusion in 10 μg·kg ^-1·min ^-1.In bFGF-FG group, the parameters improved during dobutamine infusion in 5 μg · kg ^-1 ·min ^-1, of which some changed significantly (P < 0.05 or P <0.01).There were no significant differences in all variables above during dobutamine infusion in 10 μg ·kg ^-1·min ^-1 in comparison with in 5 μg·kg ^-1·min ^-1 (P >0.05). CONCLUSION: TMLR can improve the perfusion of acute ischemic myocardium, and TMLR combined with bFGF-FG can enhance improvement of myocardial perfusion to maintain the viability of ischemic myocardium and prevent the cardiac regional and global function from advancing impairment in acute myocardial ischemia.

Key words: ischemic heart disease, transmyocardial laser revascularization, basic fibroblast growth factor, myocardial viability, ventricular function, echocardiography