Myocardial protection with pinacidil cardioplegia in the blood-perfused heart.
Myocardial protection with pinacidil cardioplegia in the blood-perfused heart.
复制标题
在血液灌注的心脏中用吡那地尔心脏停搏液保护心肌。
DOI：
10.1016/0003-4975(96)00164-6
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
DamianoJr,RJ
中科院分区：
文献类型：
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作者：
Lawton,JS;Harrington,GC;Allen,CT;Hsia,PW;DamianoJr,RJ
研究背景三磷酸腺苷敏感性钾通道开放剂是一种有效的血管扩张剂，在心肌缺血时具有心脏保护作用。研究钾通道开放剂吡那地尔作为心脏停搏剂的作用。五十六例心脏在灌注50 mL心脏停搏液后进行30分钟的全脑常温缺血，然后再灌注60分钟。心脏停搏液由Krebs-Henseleit溶液和单独溶剂（对照）、20 mmol KCl或吡那地尔（10、50、100、150或200 μmol/L）组成。在基线和再灌注后测量所产生的压力。与钾停搏液相比，TSPinacidil（50 μmol/L）的心肌缺血后收缩压恢复率明显优于对照组（68.3% ± 4.0%vs44.6% ± 5.5%，p < 0.05）。高钾血症组的电停搏时间明显短于其他组。线性舒张末期压力-容量关系显示，所有组缺血后斜率增加。与传统的高钾停搏相比，50 μmol/L和100 μmol/L吡那地尔组再灌注5分钟后的冠状动脉流量显著增加，15分钟后恢复至基线水平。钾通道开放剂是一类很有前途的药物，可以替代传统的高钾停搏液。
BACKGROUNDAdenosine triphosphate-sensitive potassium-channel openers are potent vasodilators that have been found to be cardioprotective during myocardial ischemia. The potassium-channel opener pinacidil was investigated to determine its efficacy as a cardioplegic agent.METHODSA blood-perfused, parabiotic, isolated rabbit heart Langendorff preparation was used. Fifty-six hearts underwent 30 minutes of global normothermic ischemia after a 50-mL infusion of cardioplegia, followed by 60 minutes of reperfusion. The cardioplegia consisted of Krebs-Henseleit solution with either vehicle alone (control), 20 mmol KCl, or pinacidil (10, 50, 100, 150, or 200 μmol/L). The developed pressure was measured at baseline and after reperfusion. Coronary blood flow was measured with an in-line ultrasonic probe.RESULTSPinacidil (50 μmol/L), as opposed to potassium cardioplegia, provided significantly better postischemic percentage recovery of developed pressure compared with controls (68.3% ± 4.0% versus 44.6% ± 5.5%; p < 0.05). The time until electrical arrest was significantly shorter in the hyperkalemic group than in all other groups. Linear end-diastolic pressure-volume relationships revealed an increase in slope after ischemia in all groups. Coronary flow after 5 minutes of reperfusion was significantly higher in both the 50-μmol/L and 100 μmol/L pinacidil groups compared with traditional hyperkalemic arrest, and this returned to baseline after 15 minutes.CONCLUSIONSThe potassium channel opener pinacidil provided dose-dependent myocardial protection during global ischemia in the blood-perfused rabbit heart model. Potassium-channel openers are a promising class of drugs that may provide an alternative to traditional hyperkalemic cardioplegia.