Low flow after global ischemia to improve postischemic myocardial function and bioenergetics
Low flow after global ischemia to improve postischemic myocardial function and bioenergetics
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DOI：
10.1097/00003246-200211000-00023
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发表时间：
2002-11-01
影响因子：
8.8
通讯作者：
Angelos, MG
中科院分区：
文献类型：
--
作者：
Klawitter, PF;Murray, HN;Angelos, MG
目的：在这项研究中，我们验证了在完全再灌注之前进行一段时间的低流量灌流改善心功能和生物能量的假设。设计：前瞻性、随机、对照动物研究，销售：研究实验室。受试者。发明：心脏在85毫米汞柱下灌流Krebs-Henseleit缓冲液。该方案包括10分钟的基础血流、15分钟的全脑缺血、5分钟的低流量缺血和30分钟的再灌流。在低流量期间，组的流量为基线流量的10%或1%。对照组给予0%低流量(全脑缺血20分钟)。测量和主要结果：连续测量左心功能。在不同时间点进行心脏冷冻夹闭，并测定代谢物。在全脑缺血后，在10%流量下，与0%流量和1%流量相比，左心功能和生物能量学都有所改善。与无流量(9.4+/-1.0mumol/g干重，p<；.01)相比，在1%流量下，再灌注期心肌功能未见改变，5‘-三磷酸腺苷浓度降低(13.2+/-1.0mumol/g干重，p<；.01)。结论：全脑缺血后再灌流前，低流量可改善缺血后心肌功能和能量恢复，但前提是达到一定程度的低流量。与持续性全脑缺血相比，非常低的血流量可能会进一步降低生物能量的恢复，而不会改善缺血后的功能。
Objective: In this study, we test the hypothesis that a period of low flow perfusion before full reperfusion improves ventricular function and bioenergetics.Design: Prospective, randomized, controlled animal study,Selling: Research laboratory.Subjects. Sprague-Dawley rats.Interventions: Hearts were perfused with Krebs-Henseleit buffer at 85 mm Hg. The protocol consisted of 10 mins of baseline flow, 15 mins of global ischemia, 5 mins of low flow ischemia, and 30 mins of reperfusion. Groups received 10% or 1% of baseline flow during the low flow period. A control group received 0% low flow (20 mins of global ischemia).Measurements and Main Results: Left ventricular function was continuously measured. Hearts were freeze-clamped at various time points, and metabolites were measured. At 10% flow, following global ischemia, both left ventricular function and bioenergetics improved compared with 0% flow and 1% flow. At 1% flow, no changes in function were seen and adenosine 5'-triphosphate concentrations decreased during reperfusion, compared with no flow (9.4 +/- 1.0 vs. 13.2 +/- 1.0 mumol/g of dry weight, p < .01).Conclusions: Following global ischemia but before full reperfusion, a period of low flow improves postischemic myocardial function and energetic recovery, only if a certain level of low flow is met. Very low flow may further reduce bioenergetic recovery without improvement in postischemic function, compared with continuous global ischemia.