Isosorbide-2-mononitrate reduces the consequences of myocardial ischaemia, including arrhythmia severity:: Implications for preconditioning
Isosorbide-2-mononitrate reduces the consequences of myocardial ischaemia, including arrhythmia severity:: Implications for preconditioning
复制标题
DOI：
10.1023/a:1007832921391
复制
发表时间：
2000-09-01
影响因子：
3.4
通讯作者：
Parratt, JR
中科院分区：
文献类型：
--
作者：
György, K;Végh, A;Parratt, JR
研究了氯氯脲麻醉犬在急性左冠状动脉前降支闭塞前及25分钟时冠状动脉内给药异山梨酯-2-单硝酸盐(ISMN; 3 μ g kg（-1) min(-1)）的影响。ISMN唯一显著的血流动力学影响是动脉血压轻微（-11 +/- 2 mmHg）降低和冠状动脉舒张期阻力降低（< 12%）。与注射了盐水的对照组相比，ISMN存在的冠状动脉闭塞导致室性心律失常的发生率和严重程度显著降低。异位心跳较少（62 +/- 35次vs 202 +/- 72次，p < 0.05），室性心动过速发生率较低（25% vs 75%, p < 0.05），发作次数较低（0.7 +/- 0.4次vs 4.3 +/- 2.1次，p < 0.05），缺血期间发生纤颤的犬较少（17% vs 82%, p < 0.05）。给予ISMN的狗在缺血-再灌注联合损伤后存活较多（50% vs 0%; p < 0.05）。在给予ISMN的狗的整个闭塞期，st段抬高的变化（由心外膜电极记录）和缺血区域内电激活的不均匀程度的变化要小得多。这些结果增加了先前报道的缺血预处理和冠状动脉内给药尼可地尔的抗心律失常作用与一氧化氮有关的假设的重要性。
The effects of the intracoronary administration of isosorbide-2-mononitrate (ISMN; 3 mu g kg(-1) min(-1)), a major metabolite of isosorbide dinitrate, were examined in chloralose-urethane anaesthetized dogs before and during a 25 min, acute occlusion of the left anterior descending coronary artery. The only significant haemodynamic effects of ISMN administration were a slight (-11 +/- 2 mmHg) decrease in arterial blood pressure and a decrease (< 12%) in diastolic coronary vascular resistance. Coronary occlusion in the presence of ISMN led to a markedly reduced incidence and severity of ventricular arrhythmias compared to those in control, saline-infused dogs. There were fewer ectopic beats (62 +/- 35 versus 202 +/- 72; p < 0.05), a lower incidence (25% versus 75%; p < 0.05) and number of episodes (0.7 +/- 0.4 versus 4.3 +/- 2.1; p < 0.05) of ventricular tachycardia and fewer dogs fibrillated during the ischaemic period (17% versus 82%; p < 0.05). More dogs given ISMN survived the combined ischaemia-reperfusion insult (50% versus 0%; p < 0.05). Changes in ST-segment elevation (recorded by epicardial electrodes) and in the degree of inhomogeneity of electrical activation within the ischaemic area were much less pronounced throughout the occlusion period in dogs given ISMN. These results add weight to the hypothesis that the previously reported antiarrhythmic effects of ischaemic preconditioning, and of the intracoronary administration of nicorandil, involve nitric oxide.