IMPACTS OF SYSTEMIC HYPERTENSION AND LEFT VENTRICULAR HYPERTROPHY ON OUTCOME OF CARDIOPULMONARY RESUSCITATION AND THERAPEUTIC HYPOTHERMIA IN A CARDIAC ARREST MODEL OF RAT
IMPACTS OF SYSTEMIC HYPERTENSION AND LEFT VENTRICULAR HYPERTROPHY ON OUTCOME OF CARDIOPULMONARY RESUSCITATION AND THERAPEUTIC HYPOTHERMIA IN A CARDIAC ARREST MODEL OF RAT
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DOI：
10.1097/shk.0000000000000510
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发表时间：
2015-10
期刊：
影响因子：
3.1
通讯作者：
Pei Wang;Lei Zhang;Yushun Gong;Hehua Zhang;Xiang Wang;Yongqin Li
中科院分区：
文献类型：
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作者：
Pei Wang;Lei Zhang;Yushun Gong;Hehua Zhang;Xiang Wang;Yongqin Li
背景：全身性高血压和左心室肥厚（LVH）是心脏骤停的主要危险因素。然而，高血压和LVH对心肺复苏（CPR）和复苏后低体温结果的影响仍不确定。方法：对16只伴有LVH的雄性自发性高血压大鼠（SHR）和16只雄性正常Wistar Kyoto大鼠（WKY）进行心室颤动（VF）治疗4 min和心肺复苏术（CPR） 4 min后，尝试除颤。当实现自发循环恢复（ROSC）时，将动物随机分为低温和常温两组。对于低温动物，ROSC后立即开始快速冷却，温度保持在33.0±0.4°C 2小时。常温动物保持在37.0±0.4°C。结果：高血压动物的基线平均动脉压、心率和左心室质量显著升高，但射血分数较低。与WKY相比，SHR组冠状动脉灌注压更高，但心肺复苏术持续时间和复苏所需除颤器次数无差异。所有动物均成功复苏，但复苏后高血压动物心功能严重受损。SHR组ROSC后血清肌钙蛋白T、氨基端前脑利钠肽和S100B水平也显著升高。14只WKY大鼠（87.5%）存活，而只有1只SHR （6.3%, P < 0.001）存活至96 h。结论：在该大鼠模型中，全身性高血压和LVH对ROSC无影响。然而，由于高血压动物心脏和脑损伤的严重程度升高，无论短期低温治疗，生存率都很低。
Background: Systemic hypertension and left ventricular hypertrophy (LVH) are major risk factors of cardiac arrest. However, the impacts of hypertension and LVH on the outcome of cardiopulmonary resuscitation (CPR) and post-resuscitation hypothermia are still undetermined. Methods: After 4 min of untreated ventricular fibrillation (VF) and 4 min of CPR, defibrillation was attempted in 16 male spontaneously hypertensive rats (SHR) with LVH and 16 male normotensive Wistar Kyoto (WKY) rats. When restoration of spontaneous circulation (ROSC) was achieved, animals were randomized into either hypothermia or normothermia. For animals subjected to hypothermia, rapid cooling was started immediately after ROSC and a temperature of 33.0 ± 0.4°C was maintained for 2 h. Normothermic animals were maintained at 37.0 ± 0.4°C. Results: Baseline mean arterial pressure, heart rate, and left ventricle mass were significantly higher but ejection fraction was lower for hypertensive animals. Coronary perfusion pressure was higher for SHR, but no differences in duration of CPR and number of defibrillations required for resuscitation compared with WKY. All of the animals were successfully resuscitated but post-resuscitation cardiac function was severely impaired in hypertensive animals. Serum levels of cardiac troponin T, amino-terminal pro-brain natriuretic peptide, and S100B measured after ROSC were also markedly higher in SHR groups. Fourteen WKY rats (87.5%) survived, whereas only 1 SHR (6.3%, P < 0.001) survived to 96 h. Conclusions: In this rat model, systemic hypertension and LVH did not affect ROSC. However, survival was dismal due to elevated severity of cardiac and cerebral injury in hypertensive animals regardless of short-duration hypothermia.