Anesthetic-induced preconditioning - Previous administration of isoflurane decreases myocardial infarct size in rabbits
Anesthetic-induced preconditioning - Previous administration of isoflurane decreases myocardial infarct size in rabbits
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DOI：
10.1097/00000542-199711000-00023
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发表时间：
1997-11-01
期刊：
影响因子：
8.8
通讯作者：
Hickey, RF
中科院分区：
文献类型：
--
作者：
Cason, BA;Gamperl, AK;Hickey, RF
背景：实验证据表明 ATP 敏感的钾通道参与心肌缺血预适应，由于异氟醚的一些药理作用是由 K-ATP 通道介导的，作者检验了这一假设：在心肌缺血前施用异氟醚可以诱导或模拟心肌预适应。方法：在三种情况下测量心肌梗死面积 异丙酚麻醉的兔子组，每组进行 30 分钟的前外侧冠状动脉闭塞，然后再灌注 3 小时。各组在预处理方面有所不同：第 I 组（对照，N = 13）无预处理，第 2 组（缺血预处理，N = 8），冠状动脉闭塞 5 分钟，再灌注 15 分钟；第 3 组（异氟烷预处理；N = If），If 分钟异氟烷（1.1% 呼气末）和 15 分钟冲洗。连续监测血流动力学。分别使用氯化三苯基四氮唑染色和荧光微球来定义心肌梗塞面积和危险区域，并使用计算机测面积法进行测量。 结果：以占危险区域百分比表示的梗塞面积为 23.4 +/- 8.5%（异氟醚组的平均值 +/- SD 相比之下，对照组为 33.1 +/- 13.3%， 缺血预处理组为 8.7 +/- 6.2%。巧合回归分析，随后进行斜率和高程相等检验，结果表明，由于线高程的差异，梗塞面积和危险面积之间的线性关系在所有三组中均显着不同（CP < 0.05）。各组之间发现血流动力学变量存在微小差异，这不太可能解释梗塞面积的显着差异， 结论：在心肌缺血前预给予异氟醚，可减少心肌梗塞面积，并模拟心肌预处理。 （修订词：心脏：缺血预处理；心肌梗塞；心肌缺血。挥发性麻醉剂：异氟烷。钾通道：ATP 敏感。）
Background: Experimental evidence suggests that ATP-sensitive potassium channels are involved in myocardial ischemic preconditioning, Because some pharmacologic effects of isoflurane are mediated by K-ATP channels, the authors tested the hypothesis: Isoflurane administration, before myocardial ischemia, can induce or mimic myocardial preconditioning.Methods: Myocardial infarct size was measured in three groups of propofol-anesthetized rabbits, each subjected to 30 min of anterolateral coronary occlusion followed by 3 h of reperfusion. Groups differed iu their pretreatment: Group I (control, N = 13) no pretreatment, Group 2 (ischemic preconditioning, N = 8), 5 min of coronary occlusion and 15 min of reperfusion; Group 3 (isoflurane pretreatment; N = If), If min of isoflurane (1.1% end-tidal) and 15 min of washout. Hemodynamics were monitored serially. Myocardial infarct size and the area at risk were defined using triphenyltetrazolium chloride staining and fluorescent microspheres, respectively, and both were measured using computerized planimetry.Results: Infarct size ex-pressed as a percentage of area at risk was 23.4 +/- 8.5% (mean +/- SD in the isoflurane group compared with 33.1 +/- 13.3% in controls, and 8.7 +/- 6.2% in the ischemia-preconditioned group. Analysis for coincidental regressions, followed by tests for equality of slope and elevation, showed that the linear relationship between infarct size and area at risk was significantly CP < 0.05) different in all three groups because of differences in line elevation, Minor differences in hemodynamic variables were found between groups, which were unlikely to account for the significant differences in infarct size, Conclusion: Preadministration of isoflurane, before myocardial ischemia, reduces myocardial infarct size, and mimics myocardial preconditioning. (Rev words: Heart: ischemic preconditioning; myocardial infarction; myocardial ischemia. Anesthetics, volatile: isoflurane. Potassium channel: ATP-sensitive.)