Enhancement of salvage of reperfused ischemic myocardium by diltiazem.
Enhancement of salvage of reperfused ischemic myocardium by diltiazem.
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地尔硫卓增强再灌注缺血心肌的挽救作用。
DOI：
10.1016/s0735-1097(86)80428-4
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发表时间：
1986
影响因子：
24
通讯作者：
Bergmann,SR
中科院分区：
文献类型：
--
作者：
Knabb,RM;Rosamond,TL;Fox,KA;Sobel,BE;Bergmann,SR
为了通过再灌注最大限度地挽救缺血心肌，可能需要同时使用药理学药物。因此，在诱发血栓性冠状动脉闭塞的狗中，评估了在施用链激酶之前30分钟静脉注射地尔硫卓对心肌血流和心肌挽救的影响。采用两种独立类型的终点。利用正电子发射断层扫描对心肌灌注和梗塞程度进行无创评估。直接测量包括通过测定心肌匀浆中的肌酸激酶活性来量化心肌梗塞。在冠状动脉闭塞维持 24 小时的 10 只对照犬中，梗塞程度平均为左心室重量的 27.9 ± 11.4%。在仅给予链激酶的 8 只狗中，梗塞程度平均为左心室质量的 16.7 ± 10.0%（与对照相比，p < 0.05）。在链激酶前 30 分钟开始给予地尔硫卓（每分钟持续 15μg/kg 直至诱导死亡）的其他 9 只狗中，梗塞程度平均为左心室质量的 9.4 ± 6.7%（与单独再灌注相比，p < 0.05）。在给药剂量下，地尔硫卓不会改变冠状动脉闭塞或溶栓后的血流量、心率或平均动脉压。根据冠状动脉闭塞后正电子断层扫描和氧 15 标记水获得的灌注图像，在 16 只狗中确定危险区域，三组中相似（六只对照狗的左心室为 30.6 ± 7.3%，五只再灌注狗的左心室为 31.8 ± 4.5%）单独使用，5 只再灌注加地尔硫卓的狗为 30.5 ± 11.6%）。梗死面积以梗死面积量化，以心肌梗塞范围表示，梗死面积在闭塞后 24 小时低于碳 11 标记的棕榈酸峰值吸收的 50%，并表示为危险区域的百分比，在对照犬中平均为 89.6 ± 11.4%，在仅进行再灌注的犬中显着降低至 45.1 ± 29.8%，在对照组犬中进一步降低至 22.3 ± 16.4%。给予狗地尔硫卓和再灌注。因此，地尔硫卓的伴随治疗显着增强了冠状动脉溶栓后再灌注心肌的挽救。
Concomitant use of pharmacologie agents may be required for maximal salvage of ischemic myocardium by reperfusion. Accordingly, in dogs with induced thrombotic coronary occlusion, the effects of intravenous dil-tiazem given 30 minutes before administration of streptokinase on myocardial blood flow and myocardial salvage were evaluated. Two independent types of end points were employed. Positron emission tomography was utilized for noninvasive assessment of myocardial perfusion and infarct extent. Direct measurements included quantification of myocardial infarction by assay of creatine kinase activity in myocardial homogenates. Infarct extent averaged 27.9 ± 11.4% of left ventricular weight in 10 control dogs in which coronary occlusion was maintained for 24 hours. In eight dogs given streptokinase alone, the infarct extent averaged 16.7 ± 10.0% of left ventricular mass (p < 0.05 versus control). In nine other dogs given diltiazem (15μg/kg per min continuously until death was induced) beginning 30 minutes before streptokinase, infarct extent averaged 9.4 ± 6.7% of left ventricular mass (p < 0.05 compared with reperfusion alone). At the dose administered, diltiazem did not alter blood flow, heart rate or mean arterial pressure after coronary occlusion or thrombolysis.The region at risk, determined in 16 dogs from perfusion images obtained with positron tomography and oxygen-15-labeled water after coronary occlusion, was similar in the three groups (30.6 ± 7.3% of the left ventricle in six control dogs, 31.8 ± 4.5% in five dogs with reperfusion alone and 30.5 ± 11.6% in five dogs with reperfusion plus diltiazem). Infarct size quantified in terms of the extent of myocardium exhibiting less than 50% of peak carbon-11-labeled palmitate uptake 24 hours after occlusion and expressed as the percent of the region at risk averaged 89.6 ± 11.4% in control dogs, was significantly reduced to 45.1 ± 29.8% in dogs with re-perfusion alone and was reduced further to 22.3 ± 16.4% in dogs given diltiazem and reperfusion. Thus, concomitant treatment with diltiazem markedly enhances salvage of reperfused myocardium after coronary thrombolysis.
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影响因子：
10.5
作者：
K. A. Fox;S. R. Bergmann;B. Sobel
通讯作者：
K. A. Fox;S. R. Bergmann;B. Sobel
正电子发射计算机断层扫描中的心电图门控。
影响因子：
1.3
作者：
E. Hoffman;M. Phelps;G. Wisenberg;H. Schelbert;D. Kuhl
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D. Kuhl
钙拮抗剂维拉帕米对犬暂时冠状动脉闭塞后坏死的影响
影响因子：
37.8
作者：
K. Reimer;J. Lowe;R. Jennings
通讯作者：
R. Jennings
麻醉犬冠状动脉再灌注后心肌出血的时程及特征
影响因子：
37.8
作者：
L. Higginson;D. Beanlands;Vera Temple;K. Sheldrick
通讯作者：
K. Sheldrick
兔实验性心肌梗死后心肌肌酸磷酸激酶活性降低
影响因子：
20.1
作者：
J. Kjekshus;B. Sobel
通讯作者：
B. Sobel