Development of cardioplegia for newborn cardiac surgery.

新生儿心脏手术心脏停跳液的开发。

• 批准号: 15390408
• 负责人: UEDA Yuuichi
• 金额: $ 2.37万
• 依托单位: Nagoya University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-15390408/
• 关键词: Glycolysis; deoxyglucose; glibenclamide; immature myocardium; cardioplegia; I_<KATP> channel; deoxyglucose; I_<KATP> channel; Na; H交換機構; Ca交換機構; Amiloride; 虚血再灌流障害; Na^+; Ca^<2+>交換機構; H^+交換機構

To elucidate the role of anaerobic glycolysis durnig ischemia for the genesis of subsequentreperfusion injury in neonatal hearts, we investigated the effects of glucose and deoxyglucose(DG) on isolated neborn(2-5 days) rabbit hearts perfused in vitro. Following cardiac arrest induced by St. Thomas' Hospital cardioplegic solution(ST), the hearts were subjected to hypothermic ischemia for 180 min. Glucose(5mM) or DG(5mM) was added to ST. Percentage recovery of left ventricular developed pressure(LVDP) after 30 min reperfusion, lactate/pyruvate ratio(L/P) in the coronary effluent during the first minute of reperfusion and CK leakage were as follows(^*p<0.05 vs ST, ANOVA) :%rec LVDP L/P ratio CK leakageST 72.7+3.3 23.3+1.2 41.5+13.0ST+glucose 58.9+3.9^* 36.9+4.4^* 40.0+5.3ST+DG 96.3+1.4^* 17.3+3.8^* 18.9+4.5^*Addition of glucose resulted in a decrease in % rec of LVDP and an increase in L/P, an index of redox state. DG application caused a significant increase in % rec of LVDP and a decrease in L/P as well as in CK leakage. These results suggested that anaerobic glycolysis during in neonatal hearts during ischemia mya set a stage for larger Ca overload with Na+/H+ and Na+/Ca2+ exchange, leading to greater myocardioal injury. potential usefulness of DG in cardioplegia was proposed.

为探讨缺血缺氧性糖酵解在新生兔心脏再灌注损伤中的作用，本实验观察了葡萄糖和脱氧葡萄糖（DG）对新生兔离体心脏缺血再灌注损伤的影响。托马斯医院心脏停搏液（ST）诱导心脏停搏后，低温缺血180分钟，ST中加入葡萄糖（5mM）或DG（5mM），再灌注30分钟后左室发展压（LVDP）恢复百分比，再灌注第1分钟冠脉流出液中的乳酸/丙酮酸比值（L/P）和CK渗漏如下（^* p <0.05 vs ST，ANOVA）：% rec LVDP L/P比率CK渗漏ST 72.7 + 3.3 23.3 + 1.2 41.5 + 13.0 ST+葡萄糖58.9 + 3.9 ^* 36.9 + 4.4 ^* 40.0 + 5.3ST + DG 96.3 + 1.4 ^* 17.3 + 3.8 ^* 18.9 + 4.5 ^* 添加葡萄糖导致LVDP % rec降低和L/P增加，L/P是氧化还原状态的指数。DG的应用导致了LVDP的% rec的显着增加和L/P以及CK泄漏的下降。结果提示，缺血心肌无氧糖酵解为心肌细胞Na +/H+和Na +/Ca~（2+）交换造成更大的钙超载，导致心肌损伤。提出DG在心脏停搏液中的潜在用途。