Bito A, Inoue K, Asano M, Ando S, Takaba T
First Department of Surgery, Showa University School of Medicine, Tokyo, Japan.
Jpn J Thorac Cardiovasc Surg. 2000 May;48(5):280-90. doi: 10.1007/BF03218140.
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.
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.
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.
利多卡因通过急性抑制心肌细胞钠内流发挥心脏停搏作用。就心肌细胞的心脏功能和钙动力学而言,我们研究了添加具有出色氧运输功能以满足心肌氧需求的全氟化合物FC43对利多卡因诱导的心脏停搏的心肌保护作用。
采用Langendorff模式灌注离体大鼠心脏,并将其分为三个实验组。在保存过程中,用以下三种溶液连续灌注这些心脏,第一组(A组)在 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)在 Krebs-Henseleit 碳酸氢盐缓冲液中加入2 mM利多卡因,第三组(C组)在 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,测量A组和B组心脏停搏期间的心脏功能和细胞内钙浓度。此外,连续冠状动脉灌注360分钟后,测量B组和C组的心脏功能。
利多卡因心脏停搏显示出良好的心脏功能恢复,因为利多卡因通过阻断钠内流诱导迅速的心脏停搏,并通过随后抑制钠钙通道抑制细胞内钙超载。此外,我们的结果表明,将全氟化合物与利多卡因联合使用可产生更有效的心肌保护作用,满足长期心脏停搏期间的心肌氧需求。