Vágó Hajnalka, Soós Pál, Zima Endre, Gellér László, Keltai Katalin, Róka Attila, Kékesi Violetta, Juhász-Nagy Alexander, Merkely Béla
Department of Cardiovascular Surgery, Semmelweis University Budapest, Hungary.
J Cardiovasc Pharmacol. 2004 Nov;44 Suppl 1:S376-9.
Myocardial ischemia-reperfusion is associated with increased production of endothelin-1 (ET-1). Moreover, exogenous ET-1 has arrhythmogenic properties. Our aim was to investigate the correlation between endogenous ET-1, big ET-1 levels and epicardial monophasic action potential duration during myocardial ischemia-reperfusion in anesthetized dogs. Thirty-minute myocardial ischemia was followed by a 90-minute reperfusion period in 18 mongrel dogs. The total incidence of ventricular fibrillation (VF) during ischemia and reperfusion was 11.1% and 33.3%, respectively. During ischemia, the monophasic action potential duration at 90% repolarization (MAPD90) decreased significantly (control versus ischemia, 30 minutes, 224.7 +/- 7.1 ms versus 173.8 +/- 7.6 ms; P < 0.05), while during reperfusion a significant prolongation of MAPD90 was observed (ischemia, 30 minutes versus reperfusion, 30 minutes, 173.8 +/- 7.6 ms versus 249.7 +/- 9.9 ms, P < 0.05). During reperfusion ET-1 and big ET-1 levels increased significantly in the coronary sinus and femoral artery (control versus reperfusion, 90 minutes: coronary sinus ET-1, 15.1 +/- 1.4 fmol/mL versus 22.3 +/- 1.1 fmol/mL; big ET-1, 14.7 +/- 1.9 fmol/mL versus 27.4 +/- 2.3 fmol/mL; P < 0.05). The ET-1 concentration increased to a higher level during ischemia in dogs with VF compared with dogs surviving ischemia-reperfusion (non-VF versus VF: control, 15.1 +/- 1.3 versus 15.2 +/- 1.3; ischemia, 30 minutes, 17.6 +/- 1.2 fmol/mL versus 22 +/- 1.6 fmol/mL; P < 0.05), demonstrating a trend of correlation between endothelin levels and development of VF (P = 0.07). ET-1 and big ET-1 levels increased during reperfusion and in the VF group during ischemia; however, there was no correlation between endothelin levels and MAPD90.
心肌缺血再灌注与内皮素 -1(ET-1)生成增加有关。此外,外源性ET-1具有致心律失常特性。我们的目的是研究麻醉犬心肌缺血再灌注期间内源性ET-1、大ET-1水平与心外膜单相动作电位持续时间之间的相关性。18只杂种犬经历30分钟心肌缺血,随后是90分钟再灌注期。缺血和再灌注期间室颤(VF)的总发生率分别为11.1%和33.3%。缺血期间,复极化90%时的单相动作电位持续时间(MAPD90)显著缩短(对照组与缺血30分钟组,224.7±7.1毫秒对173.8±7.6毫秒;P<0.05),而在再灌注期间观察到MAPD90显著延长(缺血30分钟对再灌注30分钟,173.8±7.6毫秒对249.7±9.9毫秒,P<0.05)。再灌注期间,冠状窦和股动脉中ET-1和大ET-1水平显著升高(对照组与再灌注90分钟组:冠状窦ET-1,15.1±1.4飞摩尔/毫升对22.3±1.1飞摩尔/毫升;大ET-1,14.7±1.9飞摩尔/毫升对27.4±2.3飞摩尔/毫升;P<0.05)。与缺血再灌注存活犬相比,VF犬缺血期间ET-1浓度升高至更高水平(非VF组对VF组:对照组,15.1±1.3对15.2±1.3;缺血30分钟,17.6±1.2飞摩尔/毫升对22±1.6飞摩尔/毫升;P<0.05),表明内皮素水平与VF发生之间存在相关趋势(P = 0.07)。再灌注期间以及缺血期间VF组中ET-1和大ET-1水平升高;然而,内皮素水平与MAPD90之间无相关性。