REDUCTION OF REPERFUSION INJURY IN THE CANINE PREPARATION BY INTRACORONARY ADENOSINE - IMPORTANCE OF THE ENDOTHELIUM AND THE NO-REFLOW PHENOMENON
REDUCTION OF REPERFUSION INJURY IN THE CANINE PREPARATION BY INTRACORONARY ADENOSINE - IMPORTANCE OF THE ENDOTHELIUM AND THE NO-REFLOW PHENOMENON
复制标题
DOI：
10.1161/01.cir.76.5.1135
复制
发表时间：
1987-11-01
期刊：
影响因子：
37.8
通讯作者：
VIRMANI, R
中科院分区：
文献类型：
--
作者：
OLAFSSON, B;FORMAN, MB;VIRMANI, R
我们假设内源性冠状血管扩张剂腺苷可以通过在冠状动脉闭塞再灌注的准备过程中逐渐增加回流来减少梗塞面积。近端左前降支动脉闭塞 90 分钟后，20 只狗被随机分配，以 3.75 mg/min 的速度对近端左前降支血管进行血液再灌注（n = 10）或不加入阿新苷（n = 10），再灌注 60 分钟。用微球连续测定局部心肌血流量，并通过计算机径向缩短法评估局部心室功能。 24小时时，用monastral蓝色染料在体内定义危险区域，并在左心室切片在氯化三苯基四唑中孵育后测定坏死区域。在实验过程中，两组的血流动力学变量相似。在治疗动物中，梗塞面积显着减小，以危险区域的百分比表示（9.9 .+-. 2.8% vs 40.9 .+-. 6.6%，p < .001）和左心室的百分比（4.6 .+-. 1.3% vs 18.0 .+-. 3.4%，p = .002）。这与再灌注后 24 小时缺血区径向缩短的显着改善相关（10.1.+-.2.5 对比 -2.8.+-.2.2%，p < .01）。在腺苷处理的动物中，再灌注1小时后，外侧缺血区的心内膜和心外膜区域的局部心肌血流量显着增加。光学显微镜显示缺血区中性粒细胞浸润减少，电子显微镜显示心内膜下内皮结构相对保存，治疗组中性粒细胞和毛细血管红细胞停滞减少。这些发现表明，再灌注后冠状动脉内施用腺苷可显着减少梗塞面积并改善犬制剂中缺血区的局部心室功能。
We hypothesized that the endogenous coronary vasodilator adenosine may reduce infarct size by progressively increasing reflow in the preparation of coronary occlusion-reperfusion. After 90 min of proximal left anterior descending artery occlusion, 20 dogs were randomized to blood reperfusion with (n = 10) or without (n = 10) adneosine into the proximal left anterior descending vessel at 3.75 mg/min for 60 min after reperfusion. Regional myocardial blood flow was determined serially with microspheres and regional ventricular function was assessed by a computerized radial shortening method. At 24 hr, the area at risk was defined in vivo with monastral blue dye and area of necrosis was determined after incubation of left ventricular slices in triphenyltetrazolium chloride. Hemodynamic variables were similar in the two groups during the experimental protocol. Infarct size was significantly reduced in treated animals, both when expressed as a percentage of the area at risk (9.9 .+-. 2.8% vs 40.9 .+-. 6.6%, p < .001) and as a percentage of the left ventricle (4.6 .+-. 1.3% vs 18.0 .+-. 3.4%, p = .002). This was associated with significant improvement in radial shortening in the ischemic zone 24 hr after reperfusion (10.1 .+-. 2.5 vs -2.8 .+-. 2.2%, p < .01). Regional myocardial blood flow was significantly increased in endocardial and epicardial regions from the lateral ischemic zone 1 hr after reperfusion in adenosine-treated animals. Light microscopy demonstrated decreased neutrophil infiltration in the ischemic zone and electron microscopy showed relative preservation of endothelial structure in the subendocardium with reduced neutrophil and red cell stagnation of capillaries in the treated group. These findings suggest intracoronary administration of the adenosine after reperfusion significantly reduces infarct size and improves regional ventricular function in the ischemic zone in the canine preparation.