Nifekalant hydrochloride administration during cardiopulmonary resuscitation improves the transmural dispersion of myocardial repolarization: experimental study in a canine model of cardiopulmonary arrest.
Nifekalant hydrochloride administration during cardiopulmonary resuscitation improves the transmural dispersion of myocardial repolarization: experimental study in a canine model of cardiopulmonary arrest.
复制标题
心肺复苏期间服用盐酸尼非卡兰可改善心肌复极的跨壁分散：犬心肺骤停模型的实验研究。
作者：
K. Yoshioka;M. Amino;K. Usui;Atsuhiko Sugimoto;A. Matsuzaki;Kumiko Kohzuma;Shigetaka Kanda;Yoshiaki Deguchi;Y. Ikari;I. Kodama;T. Tanabe
背景
由于盐酸尼非卡兰（NIF）对心肺骤停（CPA）患者的室性心动过速/室颤（VT/VF）显示出上级的抑制作用，尽管有一些QT间期延长，但在CPA动物模型中研究了其对左心室（LV）跨壁复极离散度（TDR）的影响。
方法和结果
8只比格犬在麻醉下造成心肌梗死，然后重复通过持续刺激和心肺复苏（CPR）诱导VT/VF。在酸中毒条件下（pH 7.26）给予NIF（0.3 mg/kg）。NIF前后Y导联心电图测量的QTc间期无明显延长。通过64导联左心室表面标测测量的激动恢复间期（ARI）显示NIF的ARI延长最小（40%），而没有最大ARI延长，因此ARI离散度降低了67%。在CPR时，插入电极的复极时间（RPT）在心内膜下和心外膜下延长了13-19%，而NIF仅延长了中层的RPT（17%），结果插入-TDR降低了82%（n=8，p<0.05）。
结论
心肺复苏时应用NIF可选择性地延长中层RPT，降低TDR。由于CPR后的心内膜下和心外膜下RPT在NIF给药前已经延长，这可能是NIF延长QT的作用未反映在体表ECG中的原因。
BACKGROUND
Because nifekalant hydrochloride (NIF) displayed a superior defibrillating effect on ventricular tachycardia/fibrillation (VT/VF) in cardiopulmonary arrest (CPA) patients, despite some QT prolongation, its effect on transmural dispersion of repolarization (TDR) in the left ventricle (LV) in an animal model of CPA was investigated.
METHODS AND RESULTS
Eight beagle dogs were created with a myocardial infarction under anesthesia, and then VT/VF induction by continuous stimulation and cardiopulmonary resuscitation (CPR) were repeated. NIF (0.3 mg/kg) was administered under acidotic conditions (pH 7.26). The QTc interval measured by Y-lead ECG showed no significant prolongation before and after NIF. The activation recovery interval (ARI) measured by 64-lead LV surface mapping showed minimum ARI prolongation (40%) by NIF without maximum ARI prolongation, and as a result the ARI dispersion decreased by 67%. The repolarization time (RPT) with the plunge electrode showed 13-19% prolongation in the subendocardium and subepicardium with CPR, but NIF prolonged the RPT in the middle layer alone (17%), and as a result Plunge-TDR decreased by 82% (n=8, p<0.05).
CONCLUSIONS
Administration of NIF during CPR decreased the TDR by RPT prolongation selectively in the middle layer. Because the subendocardial and subepicardial RPTs after CPR were already prolonged before NIF administration, it may have been the reason why the QT-prolonging effect of NIF was not reflected in the body surface ECG.
影响因子：
37.8
作者：
K. Yoshioka;D. Gao;M. Chin;C. Stillson;E. Penades;M. Lesh;W. O'Connell;M. Dae
通讯作者：
K. Yoshioka;D. Gao;M. Chin;C. Stillson;E. Penades;M. Lesh;W. O'Connell;M. Dae