缺血再灌注肝脏释放的血管活性物质对离体大鼠心脏的影响。

Effects of vasoactive substances released from ischemic reperfused liver on the isolated rat heart.

作者信息

Hochhauser E, Alterman I, Weinbroum A, Barak Y, Harell D, Raz A, Erman A, Vidne B

机构信息

The Cardiac Research Laboratory of the Department of Cardiothoracic Surgery, Felsenstein Medical Research Center;

出版信息

Exp Clin Cardiol. 2001 Spring;6(1):29-34.

PMID:20428441

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2858962/

Abstract

BACKGROUND

Cardiovascular dysfunction frequently occurs after major vascular surgery or liver transplantation.

OBJECTIVE

To evaluate the effects on myocardial activity of vasoactive agents released from ischemic-reperfused liver.

ANIMALS AND METHODS

Isolated rat livers were perfused with Krebs-Henseleit solution (KH), propranolol 10(-5) M, losartan 2x10(-5) M and indomethacin 10(-5) M, then made globally ischemic for 120 min (37 degrees C) and reperfused. Isolated hearts from other rats were stabilized with KH and reperfused for 15 min with the perfusate exiting the livers. Livers were disconnected, and the hearts continued to be recirculated with the accumulated liver and heart effluent for an additional 50 min. Enzyme leakage, different vasoactive substances, left ventricular developed pressure (LVP) and coronary flow were measured during the experimental protocol.

RESULTS

Hepatic release of adrenaline, noradrenaline, angiotensin II, prostaglandin E(2) and thromboxane B(2) was significantly increased in the liver effluent following ischemia. When this effluent was directed to the heart, LVP was significantly raised in the first 10 min of reperfusion (137+/-5%) followed by marked decreased (46+/-6%) during the following 65 min of myocardial reperfusion. In the ischemic-reperfused drug-treated groups, the initial positive effect on LVP was milder than in controls (propranolol 112+/-12%, losartan 111+/-11%, indomethacin 113+/-9%) and the final LVP was lower (propranolol 29+/-6%, losartan 27+/-7% [P<0.05 versus ischemic control], indomethacin 46 +/-12%).

CONCLUSION

During the initial phase of reperfusion, vasoactive substances released in the hepatic effluent potentiated LVP of the hearts exposed to this effluent. When the three inhibitory drugs were added to KH, this initial augmentation was not sustained. Propranolol and losartan, but not indomethacin, further depressed LVP. Vasoactive substances released from ischemic reperfused livers directly influenced heart function.

摘要

背景

心血管功能障碍常在大血管手术或肝移植后频繁发生。

目的

评估缺血再灌注肝脏释放的血管活性物质对心肌活动的影响。

动物与方法

用克雷布斯 - 亨塞尔特溶液（KH）、10⁻⁵ M普萘洛尔、2×10⁻⁵ M氯沙坦和10⁻⁵ M吲哚美辛灌注离体大鼠肝脏，然后使其整体缺血120分钟（37℃）并再灌注。用KH稳定来自其他大鼠的离体心脏，并用肝脏流出的灌注液再灌注15分钟。断开肝脏连接，心脏继续用累积的肝脏和心脏流出液再循环50分钟。在实验过程中测量酶泄漏、不同的血管活性物质、左心室舒张末压（LVP）和冠状动脉血流量。

结果

缺血后肝脏流出液中肾上腺素、去甲肾上腺素、血管紧张素II、前列腺素E₂和血栓素B₂的肝释放量显著增加。当这种流出液导向心脏时，再灌注的前10分钟LVP显著升高（137±5%），随后在心肌再灌注的接下来65分钟内显著降低（46±6%）。在缺血再灌注药物治疗组中，对LVP的初始正向作用比对照组轻（普萘洛尔112±12%，氯沙坦111±11%，吲哚美辛1,13±9%），最终LVP更低（普萘洛尔29±6%，氯沙坦27±7%[与缺血对照组相比P<0.05]，吲哚美辛46±12%）。