Evaluation of immature myocardial energy metabolism during ischemia and after reperfusion by NMR spectroscopy

核磁共振波谱法评估缺血期间和再灌注后未成熟心肌的能量代谢

• 批准号: 03454339
• 负责人: KATAYAMA Osamu
• 金额: $ 3.65万
• 依托单位: Kinki University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1992
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03454339/
• 关键词: Immature Myocardium; Ischemia; Reperfusion; Cardioplegia; NMR Spectroscopy; Rabbit Heart; ATP; 家兎; 心筋エネルギ-代謝; NMR法

Multidose infusion of crystalloid cardioplegia has been reported to be detrimental to immature myocardium by many investigators. We investigated the effect of multidose cold blood cardioplegia (CBC) on immature myocardium in comparison with St. Thomas' cardioplegia (ST). Hearts from neonatal rabbits (6-9 days) were perfused at 37 OC in the Langendorff method before and after ischemia. Myocardial viability was evaluated by NMR spectroscopy and was expressed in % of preischemic value (mean * SE). Myocardial water content was measured by the wet and dry method. Immature hearts (five in each group) received a single 10 ml infusion of each cardioplegic solution or multiple infusions ( at 15-, 30-, or 60-min.intervals ) at 15 OC during 3 hrs of ischemia. After reperfusion for 30 mins., a single dose of ST showed good recovery of ATP (91.7 * 2.6%), but more frequent infusions of ST worsened ATP recovery (63.1 * 5.0% in the 15-min. interval group,p<0.01 vs single-dose group). In contrast CBC at 15-min.intervals produced best recovery of ATP (95.1 * 3.6%), and multidose CBC infusion improved postischemic ATP recovery (75.1 * 3.7% in single-dose group, p<0.05 vs multidose groups). Myocardial water contents in ST groups were significantly higher than in CBC groups, however, they had no relationship with ATP recovery. These observations suggest that multidose cardioplegic infusion is not always detrimental to the immature heart and that the Immature heart may be more sensitive than the adult heart to the combination of cardioplegic solution and infusion method. In conclusion we have to find a suitable infusion method for the cardioplegic solution adopted.

多剂量晶体停搏液输注对未成熟心肌有损伤作用。我们研究了多剂量冷血停搏液（CBC）对未成熟心肌的作用，并与St.托马斯停搏液（ST）进行了比较。用Langendorff法于37 ℃对6-9天的新生兔心脏进行缺血前后的灌流。通过核磁共振波谱法评价心肌活力，并以缺血前值的%（平均值 * SE）表示。采用干湿法测定心肌含水量。未成熟的心脏（每组5个）在缺血3小时期间于15 ℃接受每种心脏停搏液10 ml的单次输注或多次输注（间隔15、30或60分钟）。再灌注30分钟后，ST单次给药显示ATP恢复良好（91.7 * 2.6%），但ST更频繁输注使ATP恢复恶化（15分钟间隔组为63.1 * 5.0%，p<0.01 vs单次给药组）。相反，15分钟间隔的CBC产生最佳的ATP恢复（95.1 * 3.6%），并且多剂量CBC输注改善缺血后ATP恢复（单剂量组为75.1 * 3.7%，p<0.05 vs多剂量组）。ST组心肌含水量明显高于CBC组，但与ATP恢复无关。这些观察结果表明，多剂量心脏停搏液输注并不总是有害的未成熟的心脏，未成熟的心脏可能比成人心脏更敏感的心脏停搏液和输注方法的组合。总之，我们必须找到一个合适的输注方法，心脏停搏液所采用的。