CAJ | 학술논문

目的:通过心外膜快速起搏方法建立病理生理机制与临床情况相似的房颤动物模型.方法:22只健康杂种犬,12只犬通过心外膜快速起搏8周建立持续性房颤模型(A组),10只犬为假手术组(B组).行超声检查评价起搏前后心房面积以及瓣膜返流情况,起搏8周后行电生理检查比较两组不应期变化、房颤可诱导性和持续时间.结果:起搏8周后A组犬左、右房面积显著增大,二尖瓣和三尖瓣膜出现不同程度返流.标测部位不应期测量:右心耳A组102.5±2.68 ms VS B组122.8±2.90 ms(P<0.05);右房游离壁 A组102.5±2.43 ms VS B组120.5±2.17 ms(P<0.05);右肺静脉前庭 90.2±1.59 ms VS 104±3.59 ms(P<0.05);左心耳A组 97.8±2.44 VS B组112.8±2.39 ms(P<0.05);左房游离壁 A组97.6±2.61 ms VS 111.6±4.95 ms(P<0.05);左肺静脉前庭 A组89.4±2.15 ms VS 102.2±3.08 ms(P<0.05);与B组犬相比A组在上述6个部位测量的有效不应期均显著缩短.房颤可诱导性:A组80.0%±17.0%VS B组4.4%± 8.4%;房颤最长持续时间 A组26.0±5.9 min VS B组1.5±3.4s.结论:通过心外膜快速起搏的方法建立了犬的持续性房颤的模型,可以作为非器质性心脏病所致房颤研究的良好模型.
목적:통과심외막쾌속기박방법건립병리생리궤제여림상정황상사적방전동물모형.방법:22지건강잡충견,12지견통과심외막쾌속기박8주건립지속성방전모형(A조),10지견위가수술조(B조).행초성검사평개기박전후심방면적이급판막반류정황,기박8주후행전생리검사비교량조불응기변화、방전가유도성화지속시간.결과:기박8주후A조견좌、우방면적현저증대,이첨판화삼첨판막출현불동정도반류.표측부위불응기측량:우심이A조102.5±2.68 ms VS B조122.8±2.90 ms(P<0.05);우방유리벽 A조102.5±2.43 ms VS B조120.5±2.17 ms(P<0.05);우폐정맥전정 90.2±1.59 ms VS 104±3.59 ms(P<0.05);좌심이A조 97.8±2.44 VS B조112.8±2.39 ms(P<0.05);좌방유리벽 A조97.6±2.61 ms VS 111.6±4.95 ms(P<0.05);좌폐정맥전정 A조89.4±2.15 ms VS 102.2±3.08 ms(P<0.05);여B조견상비A조재상술6개부위측량적유효불응기균현저축단.방전가유도성:A조80.0%±17.0%VS B조4.4%± 8.4%;방전최장지속시간 A조26.0±5.9 min VS B조1.5±3.4s.결론:통과심외막쾌속기박적방법건립료견적지속성방전적모형,가이작위비기질성심장병소치방전연구적량호모형.
Objective: To use rapid atrial pacing to build canine model of persistent atrial fibrillation. Methods:Twenty-two mongrel dogs were selected. Twelve dogs (Group A)were induced persistent atrial fibrillation with eight-weeks rapid atrial pacing;Ten dogs (Group B) were sham-operated. Two-dimensional echocardiography was performed in group A dogs to assess the effects of rapid atrial pacing on atrial size and valves. Electrophysiology test was performed to determine the effects of rapid atrial pacing on effective refractory period, atrial fibrillation inducibility and duration of atrial fibrillation of Group A dogs. Results: After eight weeks rapid pacing, marked biatrial enlargement was documented and valve regurgi-tation in various extent were inspected in group A. After eight weeks rapid pacing,, effective refractory period reduced sharply at all mapping sites in group A, compared with group B(right atrial appendage: 102.5±2.68 ms VS 122.8±2.90 ms;right atrial free wall 102.5±2.43 ms VS 120.5±2.17 ms;right pulmonary vein antrum 90.2±1.59 ms 104±3.59 ms;left atrial appendage 97.8±2.44 VS 112.8±2.39 ms;left atrial free wall 97.6±2.61 ms VS 111.6±4.95 ms;left pulmonary vein antrum 89.4 ±2.15 ms VS 102.2 ±3.08 ms; P<0.05). After eight weeks rapid pacing, atrial fibrillation inducibility and duration in-creased significantly in group A, compared with group B.( atrial fibrillation inducibility:80.0%±17%VS 4.4%±8.4%; atrial fibrillation duration: 26.0±5.9 min VS 1.5±3.4s;P<0.05). Conclusion:The present study demonstrated the feasibility of de-veloping a reproducible canine model of persistent AF with rapid atrial fibrillation. This model may be the experimental counterpart for study of lone atrial pacing.