Sevoflurane postconditioning converts persistent ventricular fibrillation into regular rhythm
Sevoflurane postconditioning converts persistent ventricular fibrillation into regular rhythm
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DOI：
10.1097/eja.0b013e32832a58fa
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发表时间：
2009-09
影响因子：
3.6
通讯作者：
Feng-jiang Zhang;Gang Chen;Congcong Chen;M. Yan
中科院分区：
文献类型：
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作者：
Feng-jiang Zhang;Gang Chen;Congcong Chen;M. Yan
背景和目的 最近的研究表明，缺血后处理可将持续性心室颤动转为窦性心律。麻醉后处理对心室颤动的影响尚未确定。在本研究中，我们在离体大鼠心脏模型中研究了七氟醚后处理对持续再灌注诱发的心室颤动的可能影响。方法 对离体 Langendorff 灌注大鼠心脏 (n = 80) 进行 40 分钟的整体缺血和再灌注。再灌注15分钟后出现持续性心室颤动的心脏（n = 16）被随机分配到两组中的一组：对照组（n = 8），继续再灌注25分钟而不进行任何干预，以及七氟烷后处理组（n = 8），七氟烷后处理组的大鼠心脏暴露于浓度为8.0%的七氟烷中2分钟，然后再灌注23分钟。至于第三组，其余的心脏被纳入非持续性颤动心脏组（n = 64）。分别测量左心室压力、心率、冠状动脉血流、电图和梗塞面积作为心室功能和细胞损伤的变量。结果在所有接受七氟烷后处理的心脏中观察到心室颤动转变为规则节律。在随后的再灌注过程中，所有麻醉后处理的心脏均维持规律的搏动。实验结束时，对照组的心脏均没有正常节律。再灌注结束时，与未发生持续性心室颤动的心脏相比，七氟醚后处理的心脏的冠脉流量增加。结论七氟醚后处理对持续再灌注诱发的室颤具有较强的抗心律失常作用。麻醉后处理可能有潜力成为再灌注相关心律失常的抗心律失常疗法。
Background and objective Recent studies showed that ischaemic postconditioning converted persistent ventricular fibrillation to sinus rhythm. The influence of anaesthetic postconditioning on ventricular fibrillation has not yet been determined. In the present study, we studied the possible effect of sevoflurane postconditioning on persistent reperfusion-induced ventricular fibrillation in the isolated rat heart model. Methods Isolated Langendorff-perfused rat hearts (n = 80) were subjected to 40 min of global ischaemia and reperfusion. The hearts with persistent ventricular fibrillation (n = 16) present after 15 min of reperfusion were then randomly assigned into one of the two groups: controls (n = 8), reperfusion was continued for 25 min without any intervention, and sevoflurane postconditioning (n = 8), rat hearts in the sevoflurane postconditioning group were exposed to sevoflurane at a concentration of 8.0% for 2 min followed by 23 min of reperfusion. As for the third group, the rest of the hearts were included in the nonpersistently fibrillating hearts group (n = 64). Left ventricular pressures, heart rate, coronary flow, electrogram and infarct size were measured as variables of ventricular function and cellular injury, respectively. Results Conversion of ventricular fibrillation into regular rhythm was observed in all hearts subjected to sevofluane postconditioning. Regular beating was maintained by all anaesthetic postconditioned hearts during the subsequent reperfusion. None of the hearts in the control group had normal rhythm at the end of the experiment. At the end of reperfusion, the coronary flow was increased in sevoflurane postconditioned hearts compared with the hearts that did not develop persistent ventricular fibrillation. Conclusion Sevoflurane postconditioning possesses strong antiarrhythmic effect against persistent reperfusion-induced ventricular fibrillation. Anaesthetic postconditioning may have the potential to be an antiarrhythmic therapy for reperfusion-related arrhythmias.