艾司洛尔大剂量β受体阻滞剂减轻心肌再灌注损伤

Reduction of myocardial reperfusion injury by high-dose beta-blockade with esmolol.

作者信息

Geissler H J

机构信息

Department of Cardiothoracic Surgery, University of Cologne, Germany.

出版信息

Thorac Cardiovasc Surg. 2002 Dec;50(6):367-72. doi: 10.1055/s-2002-35730.

DOI:10.1055/s-2002-35730

PMID:12457318

Abstract

BACKGROUND

Myocardial ischemia reperfusion injury may be reduced by beta-blockade. However, how myocardial salvage is affected when beta-blockade is limited to the reperfusion period is unknown. We investigated the impact of CPB and esmolol during reperfusion on infarct size and left ventricular function in two different experimental models of acute myocardial ischemia.

METHODS

In open-chest dogs, myocardial ischemia was induced by LAD occlusion in both studies. In study 1, infarct size (TTZ stain) and myocardial water content (MWC, microgravimetry) were determined, comparing reperfusion with blood and esmolol to blood without additives. Study 2 investigated the impact of esmolol on LV function (sonomicrometry, echocardiography) and MWC (microgravimetry) compared to warm blood cardioplegia in a more clinically oriented model.

RESULTS

Infarct size and MWC in reperfused myocardium were significantly reduced by esmolol during reperfusion. Global LV function was better preserved in the esmolol group, whereas no difference was seen regarding regional function.

CONCLUSIONS

Myocardial salvage may be significantly enhanced by CPB and esmolol, even when treatment with esmolol is initiated as late as with the onset of reperfusion.

摘要

背景

β受体阻滞剂可能减轻心肌缺血再灌注损伤。然而，当β受体阻滞剂仅限于再灌注期使用时，心肌挽救情况如何受到影响尚不清楚。我们在两种不同的急性心肌缺血实验模型中，研究了体外循环（CPB）和艾司洛尔在再灌注期间对梗死面积和左心室功能的影响。

方法

在两项研究中，均通过开胸犬的左前降支（LAD）闭塞诱导心肌缺血。在研究1中，测定梗死面积（TTC染色）和心肌含水量（MWC，微量称重法），将血液加艾司洛尔再灌注与无添加剂的血液再灌注进行比较。研究2在一个更具临床导向的模型中，将艾司洛尔与温血心脏停搏液相比，研究其对左心室功能（声纳测量法、超声心动图）和MWC（微量称重法）的影响。