心筋虚血再灌流障害に対する新しいコンセプト

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Several drugs adoministered during myocardial ischemic events may possess cardiac protective properties against reperfusion injuries. Using isolated perfused rat hearts, We have investigated the influence of various drugss belonging to three categories on reperfusion arrhythmias. First line of drugs were oxygen free radical scavengers. As oxygen free radical scavengers we chose human recombinant superoxide dismutase(SOD) and adult T cell leukemia-derived factor(ADF). We found that SOD and ADF had a similar strength of inhibitory effects against the reperfusion-induced arrhythmias and the effects were additive. On these results, we have come to the conclusion that oxygen free radical scavengers inhibit the reperfusion injury and that SOD and ADF have different action point. Second line of drugs were volatile anesthetics. As volatile anesthetics we examined halotahane, enflurane, isoflurane and sevoflurane. All volatile anesthetics, especially halotahane, showed potent protective effects against the reperfusion-induced arrhythmias. Even when epinephrine was given simultaneously, halothane attenuated reperfusion-induced arrhythmias. The third line of drug was intravenous anesthetic, propofol had inhibitory effects against reperfusion-induced arrhythmias. Several investigaters report that propofol has an oxygen free radical scavenging effects. Although much still remains to be done to reveal the mechanism of reperfusion-induced arrhythmia may lead the therapeutic means to protect hearts against the reperfusion injuries.