Effect of levosimendan on myocardial contractility, coronary and peripheral blood flow, and arrhythmias during coronary artery ligation and reperfusion in the in vivo pig model
Effect of levosimendan on myocardial contractility, coronary and peripheral blood flow, and arrhythmias during coronary artery ligation and reperfusion in the in vivo pig model
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DOI：
10.1136/heart.86.1.81
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发表时间：
2001-07-01
期刊：
影响因子：
5.7
通讯作者：
Pineda, C
中科院分区：
文献类型：
--
作者：
du Toit, E;Hofmann, D;Pineda, C
为了确定左西孟旦（一种钙敏化剂，其促进钙激活收缩器官）是否在严重缺血和再灌注期间改善心肌收缩功能而不加剧心律失常的发生率。在第11天，结扎左冠状动脉主干30分钟，然后再灌注30分钟。在冠状动脉结扎前30分钟静脉注射11.2 μ g/kg左西孟旦或安慰剂，随后在实验的剩余时间内连续输注0.2 μ g/kg/min左西孟旦或安慰剂。（平均值（SD）：2.6（0.5）v 2.0（0.2）l/min，p < 0.05）和全身血管阻力较低（2024（188）v 2669（424）dyne.s（-1）.cm（-5），p < 0.005）。在再灌注期间，左西孟旦增加心输出量和收缩力（LV（max）dP/dt（pos），956（118）v 784（130）mm Hg/s，p < 0.05）。缺血性室颤和心动过速的发生率在两组中相似，但左西孟旦治疗组中有更多的心脏事件（室性心动过速和室颤）（8/12左西孟旦v 1/9对照p = 0.05）。然而，在该体内局部缺血模型中，其增加了缺血期间的脑缺血事件的数量。
Objective-To determine whether levosimendan, a calcium sensitiser that facilitates the activation of the contractile apparatus by calcium, improves myocardial contractile function during severe ischaemia and reperfusion without exacerbating the incidence of arrhythmias.Design-Pigs were pretreated orally twice daily for 10 days with 0.08 mg/kg levosimendan or placebo. On day 11 the left main coronary artery was ligated for 30 minutes, followed by 30 minutes of reperfusion. A bolus dose of levosimendan, 11.2 mug/kg intravenously, or placebo was given 30 minutes before coronary ligation, followed by a continuous infusion of 0.2 mug/kg/min levosimendan or placebo for the remainder of the experiment.Results-During the ischaemic period, cardiac output was higher in the levosimendan group than in the placebo group (mean (SD): 2.6 (0.5) v 2.0 (0.2) l/min, p < 0.05) and systemic vascular resistance was lower (2024 (188) v 2669 (424) dyne.s(-1).cm(-5), p < 0.005). During reperfusion, cardiac output and contractility (LV(max)dP/dt (pos), 956 (118) v 784 (130) mm Hg/s, p < 0.05) were increased by levosimendan. The incidence of ischaemic ventricular fibrillation and tachycardia was similar in the two groups but there were more arrhythmic events (ventricular tachycardia and ventricular fibrillation) in the levosimendan treated group (8/12 levosimendan v 1/9 control p = 0.05).Conclusions-Levosimendan improved cardiac output and myocardial contractility during coronary artery ligation and reperfusion. However, it increased the number of arrhythmic events during ischaemia in this model of in vivo regional ischaemia.