Resuscitation Institute at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.
Resuscitation. 2010 Jan;81(1):106-10. doi: 10.1016/j.resuscitation.2009.09.013. Epub 2009 Oct 22.
Episodes of ventricular fibrillation (VF) and myocardial dysfunction commonly occur after cardiac resuscitation compromising the return of stable circulation. We investigated in a pig model of VF whether limiting Na(+)-induced cytosolic Ca(2+) overload using the sarcolemmal sodium-hydrogen exchanger isoform-1 (NHE-1) inhibitor cariporide promotes resuscitation with stable circulation.
VF was electrically induced in 20 male pigs and left untreated for 6 min after which CPR was initiated and continued for 8 min before attempting defibrillation. Pigs were randomized to receive 3-mg/kg cariporide (n=10) or 0.9%-NaCl (n=10) before chest compression.
Seven of 10 pigs in each group were successfully resuscitated and survived 2h. Cariporide ameliorated post-resuscitation ventricular ectopic activity such that fewer singlets (5+/-5 vs. 26+/-21; p<0.05) and fewer bigemini (1+/-3 vs. 33+/-25; p<0.05) were observed during the initial 5 min post-resuscitation. Additionally, cariporide-treated pigs did not require additional post-resuscitation shocks for ventricular tachycardia or recurrent VF (0.0+/-0.0 vs. 5.3+/-7.8 shocks; p=0.073). During the initial 60 min cariporide-treated pigs had higher, cardiac index (6.1+/-0.7 vs. 4.4+/-1.1L/min/m(2); p<0.01), left ventricular stroke work index (45+/-9 vs. 36+/-10 gmm/beat/m(2); p<0.05), and numerically higher mean aortic pressure (104+/-11 vs. 91+/-12 mmHg; p=0.054).
Cariporide administered at the start of chest compression may help restore electrically and mechanically stable circulation after resuscitation from cardiac arrest.
在心室颤动（VF）和心肌功能障碍的猪模型中，使用钠氢交换体 1（NHE-1）抑制剂 cariporide 限制钠诱导的细胞溶质 Ca（2+）超载，观察其是否促进复苏后循环稳定。
在 20 头雄性猪中诱发 VF，VF 后不进行治疗，6min 后开始心肺复苏（CPR），CPR 持续 8min 后尝试除颤。猪随机接受 3mg/kg cariporide（n=10）或 0.9%NaCl（n=10），然后开始胸外按压。
每组各有 10 头猪成功复苏并存活 2h。Cariporide 改善了复苏后室性异位活动，使复苏后 5min 内室性早搏（5+/-5 次比 26+/-21 次；p<0.05）和成对搏动（1+/-3 次比 33+/-25 次；p<0.05）明显减少。此外，cariporide 治疗组的猪不需要进行额外的复苏电击来治疗室性心动过速或复发性 VF（0.0+/-0.0 次比 5.3+/-7.8 次；p=0.073）。在最初的 60min 内，cariporide 治疗组的猪心输出量指数（6.1+/-0.7 比 4.4+/-1.1L/min/m（2）；p<0.01）、左心室每搏功指数（45+/-9 比 36+/-10 gmm/beat/m（2）；p<0.05）和平均主动脉压（104+/-11 比 91+/-12mmHg；p=0.054）均较高。
在心肺复苏开始时给予 cariporide，可能有助于恢复心脏骤停后电和机械稳定的循环。
