Experimental Myocardial Preservation Study of adding Perfluorochemicals (FC43) in Lidocaine Cardioplegia

目的：利多卡因通过急性抑制钠流入心肌细胞表现出心脏麻痹作用。在心功能和心肌细胞钙动力学方面，我们研究了添加具有良好的氧转运功能以满足心肌氧需求的全氟化学品FC43对利多卡因致心脏骤停的心肌保护作用。方法：用Langendorff模型灌注离体大鼠心脏，分为3个实验组。保存期间连续灌注三种溶液，第一组（A组）向Krebs-Henseleit碳酸氢盐缓冲液中加入氯化钾使钾浓度达到20 mM，第二组（B组）向Krebs-Henseleit碳酸氢盐缓冲液中加入2 mM利多卡因，第三组（C组）向Krebs-Henseleit碳酸氢盐缓冲液中加入2 mM利多卡因和20% FC43。连续灌注60分钟后，测定A组和B组心脏骤停时心功能和细胞内钙浓度，连续冠脉灌注360分钟后，测定B组和c组心脏功能。结果与结论：利多卡因心脏骤停后心功能恢复良好；因为利多卡因通过阻断钠流入引起心脏骤停，并通过抑制钠钙通道抑制细胞内钙超载。此外，我们的研究结果表明，将全氟化学品与利多卡因联合使用可以更有效地保存心肌，满足长期心脏骤停期间心肌的耗氧量。

Objective :Lidocaine exhibits a cardioplegic action via acute inhibition of sodium influx into the myocardial cells. In terms of the cardiac function and calcium dynamics in the myocardial cells, we investigated the myocardial protective effect of addition of FC43 of perfluorochemicals, which has an excellent oxygen transport function to meet the myocardial oxygen demand, on lidocaine induced cardioplegia.Methods :Isolated rat hearts were perfused with Langendorff mode and were divided to three experimental groups. During of preservation, these hearts were perfused continuously with the next three solution, potassium chloride was added to Krebs-Henseleit bicarbonate buffer to make potassium concentration of 20 mM in the first group (Group A), 2 mM lidocaine was added to Krebs-Henseleit bicarbonate buffer in the second group (Group B), and 2 mM lidocaine and 20% FC43 were added to Krebs-Henseleit bicarbonate buffer in the third group (Group C). After 60 minutes of continuous perfusion, the cardiac function and the intracellular calcium concentration in Groups A and B during cardioplegia were measured, Furthermore, after 360 minutes of continuous coronary perfusion, the cardiac function were measured in Group B and Group C.Results and Conclusions :Lidocaine cardioplegia showed a good recovery of cardiac function, because lidocaine induced prompt cardiac arrest by blocking sodium influx and inhibited the intracellular calcium overload by the following inhibition of sodium calcium channels. Moreover, our results suggested that combining perfluorochemicals with lidocaine produced a more effective myocardial preservation that meets the myocardial oxygen demand during long term cardiac arrest.