Wang X, Yamanari H, Ohe T
Department of Cardiovascular Medicine, Okayama University Medical School, Okayama 700-8558, Japan.
Chin Med J (Engl). 1999 May;112(5):424-9.
To investigate the effects of ischemic preconditioning (PC) and ATP sensitive K+ channels (KATP(+) opener nicorandil on reperfusion arrhythmias and electrophysiology.
Langendorff-perfused rat hearts were subjected to ischemic PC with three cycles of 2 minutes of global ischemia or infusion of KATP(+) opener nicorandil with subsequent 5 minutes global ischemia and reperfusion. The incidence of reperfusion arrhythmias, ventricular fibrillation threshold (VFT), effective refractory period (ERP) and monophasic action potential duration (MAPD) of the left and right ventricles were compared to those from control rat hearts.
The results indicated that PC reduced the incidence of total arrhythmias and ventricular fibrillation during reperfusion (P < 0.05, vs controls). PC markedly delayed the onset of arrhythmia after reperfusion (P < 0.01, vs controls). PC significantly enhanced the VFT values during reperfusion and shortened the ERP and the MAPD during ischemia. VFT was restored more rapidly than that in controls. KATP+ opener nicorandil neither reduced the incidence of total arrhythmias and VF nor delayed arrhythmia onset. Nicorandil shortened ERP and MAPD90 without enhancing the VFT values, and VFT returned to normal as slowly as that in controls.
We conclude that PC protects the globally ischemic rat hearts from reperfusion arrhythmias. The antiarrhythmic effect of PC is likely to be related to a significant increase of VFT. KATP(+) opener nicorandil has no potential antiarrhythmic action and KATP(+) channels may not play a major role in the antiarrhythmic effects of ischemic PC in isolated rat hearts.
研究缺血预处理(PC)及ATP敏感性钾通道(KATP)开放剂尼可地尔对再灌注心律失常及电生理的影响。
采用Langendorff灌注大鼠心脏,进行3个周期的2分钟全心缺血的缺血预处理,或灌注KATP开放剂尼可地尔,随后进行5分钟全心缺血及再灌注。将再灌注心律失常的发生率、心室颤动阈值(VFT)、有效不应期(ERP)以及左右心室的单相动作电位时程(MAPD)与对照大鼠心脏进行比较。
结果表明,PC降低了再灌注期间总心律失常及心室颤动的发生率(P < 0.05,与对照组相比)。PC显著延迟了再灌注后心律失常的发生(P < 0.01,与对照组相比)。PC显著提高了再灌注期间的VFT值,并缩短了缺血期间的ERP和MAPD。VFT恢复速度比对照组更快。KATP开放剂尼可地尔既未降低总心律失常及室颤的发生率,也未延迟心律失常的发生。尼可地尔缩短了ERP和MAPD90,而未提高VFT值,且VFT恢复至正常的速度与对照组一样缓慢。
我们得出结论,PC可保护全心缺血的大鼠心脏免受再灌注心律失常的影响。PC的抗心律失常作用可能与VFT的显著升高有关。KATP开放剂尼可地尔无潜在抗心律失常作用,且KATP通道可能在离体大鼠心脏缺血预处理的抗心律失常作用中不发挥主要作用。