Université Pierre et Marie Curie-Paris, Université René Diderot, Paris, France.
Eur J Anaesthesiol. 2010 Sep;27(9):780-7. doi: 10.1097/EJA.0b013e328337cc0d.
The isolated heart model is widely used for the assessment of coronary vascular response under various experimental conditions. As medium perfusate influences oxygenation conditions, coronary vascular response and myocardial consumption performance may differ between isolated hearts perfused with from with Krebs-Henseleit solution or Krebs-Henseleit mixed with red blood cells (KH-RBC).
Coronary vascular response to endothelium-dependent and independent vasodilators as well as myocardial performance and oxygen consumption to isoproterenol infusion were compared in isolated rabbit hearts perfused with Krebs-Henseleit or KH-RBC. Krebs-Henseleit perfusate was equilibrated with 95% oxygen and 5% carbon dioxide, KH-RBC (haemoglobin 8.0 +/- 1.1 g.dl) with 20% oxygen, 5% carbon dioxide, and 75% nitrogen. The perfusion pressure was kept constant so that coronary blood flow (CBF) varied with coronary resistance. Data are mean +/- SD.
Bradykinin induced a greater increase in CBF in KH-RBC-perfused hearts than in Krebs-Henseleit-perfused hearts (263 +/- 78 versus 134 +/- 35% of baseline, P < 0.001). Sodium nitroprusside induced a greater increase in CBF in KH-RBC-perfused than in Krebs-Henseleit-perfused hearts (257 +/- 70 versus 174 +/- 31% of baseline, P < 0.001). The increases in myocardial performance and in oxygen consumption induced by isoproterenol were greater with KH-RBC-perfused hearts than in Krebs-Henseleit-perfused hearts. A greater myoglobin release was observed in Krebs-Henseleit-perfused hearts.
Endothelium-dependent and independent coronary flow responses are increased in KH-RBC-perfused hearts. Moreover, metabolic control of CBF is altered in Krebs-Henseleit-perfused hearts. Such differences should be taken into account when pharmacologic responses of anaesthetic agents are studied.
在各种实验条件下,分离心脏模型被广泛用于评估冠状动脉血管反应。由于中灌流液会影响氧合条件,因此用 Krebs-Henseleit 溶液或 Krebs-Henseleit 混合红细胞(KH-RBC)灌流的分离心脏的冠状动脉血管反应、心肌消耗性能可能会有所不同。
在使用 Krebs-Henseleit 或 KH-RBC 灌流的分离兔心中,比较内皮依赖性和非内皮依赖性血管扩张剂引起的冠状动脉血管反应以及异丙肾上腺素输注引起的心肌性能和耗氧量。Krebs-Henseleit 灌流液用 95%氧气和 5%二氧化碳平衡,KH-RBC(血红蛋白 8.0 +/- 1.1 g.dl)用 20%氧气、5%二氧化碳和 75%氮气平衡。保持灌流压恒定,使冠状动脉血流量(CBF)随冠状动脉阻力变化而变化。数据为平均值 +/- SD。
缓激肽引起 KH-RBC 灌流心脏的 CBF 增加大于 Krebs-Henseleit 灌流心脏(263 +/- 78 对 134 +/- 35%基础值,P < 0.001)。硝普钠引起 KH-RBC 灌流心脏的 CBF 增加大于 Krebs-Henseleit 灌流心脏(257 +/- 70 对 174 +/- 31%基础值,P < 0.001)。异丙肾上腺素引起的心肌性能和耗氧量的增加在 KH-RBC 灌流心脏大于 Krebs-Henseleit 灌流心脏。Krebs-Henseleit 灌流心脏中观察到更多的肌红蛋白释放。
KH-RBC 灌流心脏的内皮依赖性和非内皮依赖性冠状动脉血流反应增加。此外,Krebs-Henseleit 灌流心脏的 CBF 代谢控制发生改变。在研究麻醉剂的药理反应时,应考虑到这些差异。