Novitzky D, Matthews N, Shawley D, Cooper D K, Zuhdi N
Oklahoma Transplantation Institute, Baptist Medical Center, Oklahoma City 73112.
Ann Thorac Surg. 1991 Jan;51(1):10-6; discussion 16-7. doi: 10.1016/0003-4975(91)90438-v.
Two groups of dogs were subjected to a 15-minute period of regional myocardial ischemia by snaring the left anterior descending coronary artery proximal to its first diagonal branch. After release of the snare, the dogs were given either placebo (group 1: n = 7) or triiodothyronine (T3) therapy (group 2: n = 6). The dose of T3 given was 0.2 microgram/kg at 30-minute intervals to a total of six doses. Plasma free T3 level fell significantly during the ischemic period in both groups and continued to fall after reperfusion in group 1. In both groups, cardiac function deteriorated significantly during the period of ischemia and rapidly returned to control level after reperfusion. After 90 minutes of reperfusion, however, deterioration of left ventricular function was observed in group 1 and was significantly worse than in group 2, in which hemodynamic function was maintained and, in fact, improved to levels superior to control. It is suggested that T3 therapy may be worthy of trial in patients in whom reperfusion of the myocardium takes place after a relatively short ischemic period (the "stunned myocardium").
两组犬通过在左前降支冠状动脉第一对角支近端套扎来造成15分钟的局部心肌缺血。松开套扎后，给犬分别注射安慰剂（第1组：n = 7）或三碘甲状腺原氨酸（T3）治疗（第2组：n = 6）。T3的给药剂量为0.2微克/千克，每隔30分钟给药一次，共给药六次。两组在缺血期血浆游离T3水平均显著下降，第1组在再灌注后仍持续下降。两组在缺血期心脏功能均显著恶化，再灌注后迅速恢复至对照水平。然而，再灌注90分钟后，第1组出现左心室功能恶化，且明显比第2组严重，第2组血流动力学功能得以维持，实际上还改善至优于对照的水平。提示对于在相对较短缺血期后发生心肌再灌注的患者（“心肌顿抑”），T3治疗可能值得一试。
