Fan Qian, Yang Xin Chun, Cao Xue Bin, Wang Shu Yan, Yang Shu Ling, Liu Xiu Lan, Gao Feng
Heart Center, Beijing Chaoyang Hospital-Affiliate of Capital University of Medical Sciences, PR China.
J Cardiovasc Pharmacol. 2006 Mar;47(3):405-12. doi: 10.1097/01.fjc.0000210073.48991.bf.
This study examined the potential deleterious effect of high-dose nitroglycerin (NTG) on cardiac function and cellular injury after ischemia (30 min) and reperfusion (120 min) in isolated perfused rat hearts. Low-dose (0.75 microg/h), medium-dose (3.75 microg/h), high-dose (15 microg/h) NTG or high-dose NTG plus glutathione (GSH, 1 mmol/L) was administrated at the time of reperfusion. Administration of high-dose NTG significantly exacerbated cardiac reperfusion injury as evidenced by increased creatine kinase and lactate dehydrogenase activity in coronary effluent, increased cardiomyocyte apoptosis and necrosis, and decreased cardiac function recovery after reperfusion. Compared with the vehicle group, formation of nitrotyrosine, a footprint for peroxynitrite (ONOO) production, was markedly increased in the hearts treated with medium-dose or high-dose NTG. Most interestingly, cotreatment with GSH blocked high-dose NTG-induced ONOO formation and attenuated myocardial ischemia/reperfusion injury. Taken together, our present results demonstrated that administration of high-dose NTG aggravated, rather than attenuated myocardial ischemia/reperfusion injury likely via increasing ONOO formation. Coadministration of GSH may reverse the advert action of high-dose NTG.
本研究检测了高剂量硝酸甘油(NTG)对离体灌注大鼠心脏缺血(30分钟)及再灌注(120分钟)后心脏功能和细胞损伤的潜在有害作用。在再灌注时给予低剂量(0.75微克/小时)、中剂量(3.75微克/小时)、高剂量(15微克/小时)NTG或高剂量NTG加谷胱甘肽(GSH,1毫摩尔/升)。高剂量NTG给药显著加剧了心脏再灌注损伤,表现为冠脉流出液中肌酸激酶和乳酸脱氢酶活性增加、心肌细胞凋亡和坏死增加以及再灌注后心脏功能恢复降低。与溶剂对照组相比,用中剂量或高剂量NTG处理的心脏中,作为过氧亚硝酸盐(ONOO)产生标志的硝基酪氨酸形成显著增加。最有趣的是,GSH共同处理可阻断高剂量NTG诱导的ONOO形成并减轻心肌缺血/再灌注损伤。综上所述,我们目前的结果表明,高剂量NTG给药加重而非减轻心肌缺血/再灌注损伤,可能是通过增加ONOO形成。GSH共同给药可能会逆转高剂量NTG的不良作用。