Mizushima M
Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1990 May;65(3):298-310.
The effects of dichloroacetate (DCA), which is known to have a beneficial effect on lactic acidosis, were examined on myocardial acidosis during coronary occlusion in dogs. Ischemia was induced by complete ligation of the left anterior descending coronary artery (LAD) of the open-chest dog heart. DCA 100 mg/kg or 200 mg/kg was administered intravenously 10 or 60 min prior to the occlusion of LAD. DCA did not change the LAD flow, decreased heart rate, increased both systolic and diastolic blood pressures transiently. LAD occlusion significantly increased the ST segment of the epicardial ECG in the saline-treated group. DCA administered prior to the LAD occlusion caused 50% decrease of the elevation in ST segment during ischemia. Ischemia accelerated anaerobic metabolism in the myocardium; the levels of glycogen, adenosine triphosphate (ATP) and creatine phosphate (CP) decreased, and lactate increased during ischemia. Calculated energy charge potential was decreased, and [( G6P] + [F6P])/[FDP] ratio was increased by ischemia. The decreased levels of glycogen, ATP, CP in DCA-treated group were similar to those in saline-treated group during 3 min ischemia. Pretreatment of DCA reduced the accumulation of myocardial lactate by ischemia. There were no differences in variables except myocardial lactate levels between DCA 100 mg/kg and 200 mg/kg. The myocardial lactate levels were lower in both nonischemic and ischemic dogs by DCA 200 mg/kg than DCA 100 mg/kg. DCA did not change either the ATP levels or energy charge potential during both ischemia and reperfusion. LAD occlusion caused a significant decrease of myocardial pH from 7.51 to 6.83 in saline-treated group, while it produced only a small decrease in DCA-treated group from 7.56 to 7.35.(ABSTRACT TRUNCATED AT 250 WORDS)
已知二氯乙酸(DCA)对乳酸性酸中毒有有益作用,本研究在犬冠状动脉闭塞期间检测了其对心肌酸中毒的影响。通过开胸犬心脏的左前降支冠状动脉(LAD)完全结扎诱导缺血。在LAD闭塞前10或60分钟静脉注射100mg/kg或200mg/kg的DCA。DCA未改变LAD血流,使心率降低,使收缩压和舒张压短暂升高。在生理盐水处理组中,LAD闭塞显著增加了心外膜心电图的ST段。在LAD闭塞前给予DCA可使缺血期间ST段抬高降低50%。缺血加速了心肌中的无氧代谢;缺血期间糖原、三磷酸腺苷(ATP)和磷酸肌酸(CP)水平降低,乳酸增加。计算得出的能荷电位降低,且缺血使[(G6P]+[F6P])/[FDP]比值升高。在3分钟缺血期间,DCA处理组中糖原、ATP、CP水平的降低与生理盐水处理组相似。DCA预处理减少了缺血引起的心肌乳酸积累。100mg/kg和200mg/kg的DCA之间,除心肌乳酸水平外,其他变量无差异。200mg/kg的DCA使非缺血和缺血犬的心肌乳酸水平均低于100mg/kg的DCA。DCA在缺血和再灌注期间均未改变ATP水平或能荷电位。在生理盐水处理组中,LAD闭塞使心肌pH值从7.51显著降至6.83,而在DCA处理组中仅从7.56小幅降至7.35。(摘要截断于250字)