Rodrigues A J, Sader A A, Vicente W V, Bassetto S
Thoracic and Cardiovascular Surgery Discipline, Department of Surgery, Orthopedia and Traumatology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Heart Surg Forum. 1999;2(1):70-6.
We investigated the degree of myocardial protection provided by intermittent anterograde normothermic blood cardioplegia infusion for 60 minutes at 37 degrees C in normal rabbit hearts.
Thirty-two New Zealand rabbits were studied and divided into two groups: experimental group and control group. In the experimental group, normothermic blood cardioplegia was infused into the aortic root every 20 minutes over a one-hour period using a two-minute infusion dose. This amounted to an ischemic (unperfused) time of 52 minutes (or 86.6% of the total time). The biochemical investigation was carried out in two phases; Phase I: metabolic study after ischemia with no reperfusion and Phase II: metabolic and functional study after reperfusion. Reperfusion was carried out using a parabiotic perfusion system. Myocardial glycogen and mitochondrial respiration in the ventricular myocardium were established immediately after the end of intermittent cardioplegic solution infusion (Phase I) and after blood reperfusion (Phase II), when left ventricular function (dP/dt max) was also evaluated.
At the end of Phase I, there was a significant decrease in myocardial glycogen levels to 58% compared with the control group. In Phase II, the differences in myocardial glycogen between the experimental and the control group were not significant. Mitochondrial respiration analysis did not show significant differences between the experimental and control groups, either in Phase I or II. In Phase I, dP/dtmax values were 903.39 +/- 113.46 mmHg/sec and 1,043 +/- 256.94 mmHg/sec for the experimental and control group, respectively. These differences were not statistically significant.
Intermittent anterograde blood cardioplegia infusion every 20 minutes for 60 minutes at 37 degrees C was an effective myocardial protection method in normal rabbit hearts.
我们研究了在正常兔心脏中,于37℃下间歇性顺行常温血液停搏液输注60分钟所提供的心肌保护程度。
对32只新西兰兔进行研究并分为两组:实验组和对照组。在实验组中,使用两分钟的输注剂量,在一小时内每隔20分钟向主动脉根部输注常温血液停搏液。这相当于52分钟的缺血(未灌注)时间(或总时间的86.6%)。生化研究分两个阶段进行;第一阶段:无再灌注的缺血后代谢研究,第二阶段:再灌注后的代谢和功能研究。使用联体灌注系统进行再灌注。在间歇性停搏液输注结束后(第一阶段)以及血液再灌注后(第二阶段),立即测定心室心肌中的心肌糖原和线粒体呼吸,同时评估左心室功能(dP/dt max)。
在第一阶段结束时,与对照组相比,心肌糖原水平显著下降至58%。在第二阶段,实验组和对照组之间的心肌糖原差异不显著。线粒体呼吸分析在第一阶段或第二阶段中,实验组和对照组之间均未显示出显著差异。在第一阶段,实验组和对照组的dP/dtmax值分别为903.39±113.46 mmHg/秒和1,043±256.94 mmHg/秒。这些差异无统计学意义。
在正常兔心脏中,于37℃下每隔20分钟间歇性顺行血液停搏液输注60分钟是一种有效的心肌保护方法。