Basic Research for Prevention of Myocardial Infarction during Dental Treatment

随着老龄化社会的到来，大多数老年牙科患者出现了许多并发症。其中最严重的疾病是无症状性心绞痛和心肌梗塞。在牙科手术中，预防此类心源性休克的发生是非常必要的。在动物和人类中，三磷酸腺苷作为一种有效的血管扩张剂，已经被我们用于降压麻醉。因此，我们期望在牙科治疗中对心肌梗死或无症状性心绞痛患者给予三磷酸腺苷的应用将有助于预防心脏病发作。本基础研究的目的是检测三磷酸腺苷对兔开放跳动心脏的扩张作用。用极谱法测左室心肌组织氧分压(Pt02)和一氧化氮(CtNO)，以评价三磷酸腺苷(ATP)或硝酸甘油(TNG)对冠脉左降支结扎15min的影响。给予ATP后，RBF和Pt02均较给予TNG时增加，且ATP控制左室心肌中CTNO的最小释放量。这些结果表明，在急性心肌梗死时，ATP可以有效地再灌流冠状动脉狭窄和梗塞。我们希望尝试进一步的研究，以便将ATP用于牙科患者。

In the advent of the society of aged people, the most aged dental patients have many complications. The serious diseases among them are a silent angina pectoris and a myocardial infarction. It is nessesary to prevent the incidence of such a cardiogenic shock during dental procedures.ATP as a potent vasodilator both in animals and human beings has been used for hypotensive anesthesia by us. So we expect that the administration of ATP to the patients with the myocardial infraction or the silent angina pectoris will be useful to prevent the heart attack during dental treatments.The aim of this basic research is to detect the coronary vasodilative effects of ATP on the opened beating heart in rabbit.The regional blood flow (RBF) was measured in the heart by the colored microspheres method. The myocardial tissue oxygen tension (Pt02) and nitric oxygen tension (CtNO) were also determined in the left ventricular myocardium by the polarography method to evaluate the effect of ATP.ATP or glycerin trinitrate (TNG) was administrated after 15 minutes' ligation of left descending coronary artery. The administration of ATP more increased both RBF amd Pt02 than the administration of TNG.Also ATP controlled minimum release of CtNO from the left ventricular myocardium.These results suggest that a coronary stenosis and infarction in a case of the acute myocardial attack might be effectively reperfused by ATP.We would like to try further investigations so as to use ATP to dental patients.