Use Tadasuke, Makita Tetsuji, Ureshino Hiroyuki, Cho Sungsam, Yoshitomi Osamu, Akiyama Daiji, Oshibuchi Motoko, Hara Tetsuya, Sumikawa Koji
Department of Anesthesiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, Japan.
Cardiovasc Drugs Ther. 2006 Oct;20(5):327-34. doi: 10.1007/s10557-006-0166-7.
We assessed the dose or timing effect of milrinone administered against myocardial stunning in 37 anesthetized open-chest swine.
All swine were subjected to 12-min ischemia followed by reperfusion to produce myocardial stunning. Group A (n = 12) received saline in place of milrinone both before and after ischemia. Group B (n = 9) and C (n = 9) received intravenous milrinone at a rate of 5 microg/kg/min for 10 min followed by 0.5 microg/kg/min for 10 min and 10 microg/kg/min for 10 min followed by 1 microg/kg/min for 10 min, respectively, until 30 min before coronary occlusion. Group D (n = 7) received the same dose of milrinone as group B starting 1 min after reperfusion. Myocardial contractility was assessed by percentage segment shortening (%SS).
Five swine in group A and two swine in groups B and C each had ventricular fibrillation or tachycardia after reperfusion, and were thus excluded from further analysis. The percentage changes of %SS from the baseline 90 min after reperfusion in groups B, C, and D were 78 +/- 9%, 82 +/- 13%, and 79 +/- 7%, respectively, which were significantly higher than those in group A (43 +/- 13%).
We conclude that milrinone administered before ischemia or just after reperfusion attenuates myocardial stunning.
我们评估了米力农给药的剂量或时间对37只麻醉开胸猪心肌顿抑的影响。
所有猪均经历12分钟的缺血,随后再灌注以产生心肌顿抑。A组(n = 12)在缺血前后均接受生理盐水代替米力农。B组(n = 9)和C组(n = 9)分别在冠状动脉闭塞前30分钟,以5微克/千克/分钟的速率静脉注射米力农10分钟,随后以0.5微克/千克/分钟的速率注射10分钟,以及以10微克/千克/分钟的速率注射10分钟,随后以1微克/千克/分钟的速率注射10分钟。D组(n = 7)在再灌注后1分钟开始接受与B组相同剂量的米力农。通过节段缩短百分比(%SS)评估心肌收缩力。
A组中有5只猪,B组和C组各有2只猪在再灌注后出现心室颤动或心动过速,因此被排除在进一步分析之外。B组、C组和D组在再灌注后90分钟时,%SS相对于基线的百分比变化分别为78±9%、82±13%和79±7%,显著高于A组(43±13%)。
我们得出结论,在缺血前或再灌注后立即给予米力农可减轻心肌顿抑。