Juggi J S, Mesaeli N, Yousof A M
Department of Physiology, Faculty of Medicine, Kuwait University, Safat.
Can J Cardiol. 1992 May;8(4):387-95.
The effects of plain ischemia (34 degrees C) and the protective role of hypothermia (20 degrees C) alone or in combination with cardioplegia (St Thomas' Hospital [STH] or glucose-potassium-nifedipine [GPN]) on the intracellular kinetics of the activator calcium of cardiac muscle were quantified and compared from the interval-force behaviour (mechanical restitution) of right and left ventricles of the perfused rat heart. Plain ischemia caused a major depression in the restitution of force of contraction of both ventricles, deranged the mixed linear-exponential functions by significantly increasing the time constants of the fitted mechanical restitution curves (MRC) and altered the control right/left ventricle interval-force relationship. The right ventricle was found to be more susceptible to ischemic damage than the left ventricle, and its inotropic reserve was virtually abolished by 1 h of plain ischemia. Hypothermic preservation during ischemia improved the mechanical restitution, salvaged the inotropic reserve and optimized right/left ventricle interval-force relationship, but the time constants of the fitted MRCs were still prolonged. However, both the cardioplegic formulations were equally effective in normalizing the time constants of the fitted curves. In general, right ventricle functions were better preserved by STH cardioplegia and left ventricle functions were better preserved by GPN cardioplegia. Cardioplegic interventions did not further improve the ventricular inotropic reserve compared with hypothermic preservation. Additional beneficial effects of cardioplegic formulations were directed towards stabilizing the linear-exponential functions and hence restitution of force of contraction.(ABSTRACT TRUNCATED AT 250 WORDS)
通过灌注大鼠心脏左右心室的间期-力行为(机械恢复),对单纯缺血(34摄氏度)以及低温(20摄氏度)单独或与心脏停搏液(圣托马斯医院[STH]或葡萄糖-钾-硝苯地平[GPN])联合使用对心肌激活钙细胞内动力学的影响进行了量化和比较。单纯缺血导致两个心室收缩力恢复的显著降低,通过显著增加拟合机械恢复曲线(MRC)的时间常数扰乱了混合线性-指数函数,并改变了对照右/左心室间期-力关系。发现右心室比左心室更容易受到缺血损伤,单纯缺血1小时实际上消除了其变力储备。缺血期间的低温保存改善了机械恢复,挽救了变力储备并优化了右/左心室间期-力关系,但拟合MRC的时间常数仍然延长。然而,两种心脏停搏液配方在使拟合曲线的时间常数正常化方面同样有效。一般来说,STH心脏停搏液能更好地保存右心室功能,GPN心脏停搏液能更好地保存左心室功能。与低温保存相比,心脏停搏干预并没有进一步改善心室变力储备。心脏停搏液配方的额外有益作用是稳定线性-指数函数,从而恢复收缩力。(摘要截断于250字)