Nicorandil Attenuates Reperfusion Injury after Long Cardioplegic Arrest
Nicorandil Attenuates Reperfusion Injury after Long Cardioplegic Arrest
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DOI：
10.1177/021849230701500306
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发表时间：
2007-06
影响因子：
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通讯作者：
K. Takarabe;Y. Okazaki;S. Higuchi;J. Murayama;M. Natsuaki;T. Itoh
中科院分区：
文献类型：
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作者：
K. Takarabe;Y. Okazaki;S. Higuchi;J. Murayama;M. Natsuaki;T. Itoh
使用手术相关的4小时心脏停搏模型确定尼可地尔在心脏手术中的心脏保护作用。每只离体兔心脏采用改良Langendorff柱进行离体血液灌注。在缺血前（基线）和缺血后测量左心室发展压力的大小和发展压力随时间的变化率。尼可地尔在缺血前、缺血后、缺血前/后或连续（缺血前、缺血期间和缺血后）给药。扫描电镜观察冠状动脉内皮细胞。同时测定血清髓过氧化物酶活性。尽管尼可地尔预处理不影响发达压力的恢复，但缺血后或缺血前后给予尼可地尔可促进发达压力的恢复。血清髓过氧化物酶活性在缺血前/后和持续组中降低。所有尼可地尔治疗组的内皮再灌注损伤均减少。尼可地尔给药可减轻心肌和冠状动脉内皮的缺血再灌注损伤，同时改善白细胞活化。如果发生非预期的长时间心脏停搏，尼可地尔给药，即使是在刚解除夹闭后，也可能改善心脏功能。然而，缺血前给药单独是没有帮助的心脏进行长时间的心脏停搏。
The cardioprotective efficacy of nicorandil in cardiac surgery was determined using a surgically relevant 4-hr cardioplegic arrest model. Each isolated rabbit heart was parabiotically blood-perfused using a modified Langendorff column. The magnitude of left ventricular developed pressure and rate of change of developed pressure over time were measured before (baseline) and after ischemia. Nicorandil was administered either pre-ischemia, post-ischemia, pre/post-ischemia, or continuously (before, during, and after ischemia). The endothelium of the coronary artery was observed by scanning electron microscopy. Serum myeloperoxidase activities were also measured. Although pretreatment with nicorandil did not affect recovery of developed pressure, administration of nicorandil after ischemia, or before and after ischemia, enhanced the recovery of developed pressure. Serum myeloperoxidase activity was decreased in the pre/post-ischemia and continuous groups. Endothelial reperfusion injury decreased in all nicorandil-treated groups. Administration of nicorandil attenuated ischemia-reperfusion injury of the myocardium and coronary endothelium while ameliorating leukocyte activation. In the event of unexpected prolonged cardioplegic arrest, administration of nicorandil, even just after declamping, may improve cardiac function. However, pre-ischemia administration alone was not helpful in the heart subjected to prolonged cardioplegic arrest.