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血栓素A2合成酶抑制剂对冠状动脉闭塞和再灌注期间室颤阈值的影响。

Effects of a thromboxane A2 synthetase inhibitor on ventricular fibrillation threshold during coronary artery occlusion and reperfusion.

作者信息

Toda I, Nozaki A, Kawakubo K, Murakawa Y, Inoue H, Yoshimoto N, Sugimoto T

机构信息

Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.

出版信息

Jpn Heart J. 1990 Jan;31(1):87-97. doi: 10.1536/ihj.31.87.

Abstract

The effects of a new thromboxane A2 synthetase inhibitor (DP-1904) on electrical stability of the heart were tested in anesthetized, open chest dogs. The incidence of spontaneous ventricular arrhythmias, ventricular refractory period and ventricular fibrillation threshold (VFT) during ligation of the left anterior descending coronary artery (LAD) for 180 min and after reperfusion were measured as indices of stability. Ventricular fibrillation and ventricular tachycardia occurred spontaneously after ligation of LAD in 56% of 9 control dogs and 29% of 7 dogs which received intravenous DP-1904 (100 mg) before ligation of LAD (n.s.). In the control group, the ventricular refractory period decreased in the ischemic region; consequently, the difference in refractory period duration between the ischemic and non-ischemic regions (i.e., dispersion) increased 30 min after coronary ligation (7 +/- 9 ms vs 32 +/- 17 ms, p less than 0.05). The dispersion at 30 min after coronary ligation, though, was not affected in the DP-1904 treated group (2 +/- 4 ms vs 10 +/- 9 ms, n.s.). The VFT (determined with pulse trains) decreased from 28 +/- 5 mA to 15 +/- 11 mA (p less than 0.05) 30 min after coronary ligation in the control group, but was not affected (30 +/- 0 mA vs 27 +/- 4 mA) in the DP-1904 group. The plasma concentration of thromboxane B2 decreased after DP-1904 administration (baseline vs 30 min after coronary ligation: 475 +/- 165 pg/ml vs 165 +/- 74 pg/ml, n = 3, p less than 0.05), while the concentration of 6-keto-prostaglandin F1 alpha increased gradually. In conclusion, DP-1904 prevents a decline in electrical stability in the ischemic region of the canine heart during coronary occlusion.

摘要

在麻醉开胸犬身上测试了一种新型血栓素A2合成酶抑制剂(DP - 1904)对心脏电稳定性的影响。测量了左冠状动脉前降支(LAD)结扎180分钟期间及再灌注后自发性室性心律失常的发生率、心室不应期和心室颤动阈值(VFT),以此作为稳定性指标。在9只对照犬中,56%在LAD结扎后自发出现心室颤动和室性心动过速;在7只在LAD结扎前静脉注射DP - 1904(100mg)的犬中,这一比例为29%(无显著差异)。对照组中,缺血区域的心室不应期缩短;因此,冠状动脉结扎30分钟后,缺血区和非缺血区不应期持续时间的差异(即离散度)增加(7±9毫秒对32±17毫秒,p<0.05)。然而,DP - 1904治疗组在冠状动脉结扎30分钟后的离散度未受影响(2±4毫秒对10±9毫秒,无显著差异)。对照组冠状动脉结扎30分钟后,VFT(通过脉冲序列测定)从28±5毫安降至15±11毫安(p<0.05),但DP - 1904组未受影响(30±0毫安对27±4毫安)。给予DP - 1904后,血浆血栓素B2浓度降低(冠状动脉结扎前基线值对结扎后30分钟:475±165皮克/毫升对165±74皮克/毫升,n = 3,p<0.05),而6 - 酮 - 前列腺素F1α浓度逐渐升高。总之,DP - 1904可防止犬心脏冠状动脉闭塞期间缺血区域电稳定性下降。

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