Zheng Xue-bing, Wang Rui, Yang Hai-ling, Sun Xiao-li
Department of Geriatric Medicine, China-Japan Union Hospital, Jilin University, Changchun 130033, China.
Zhonghua Yi Xue Za Zhi. 2013 Apr 16;93(15):1168-73.
To explore the impact of chloride ion channel and its blockers 4, 4'-diisothiocyanostilbene-2, 2'-disulfonic acid (DIDS), cyanato-stilbene-2, 2'-disulfonic acid (SITS) and 5-nitro-2-(3-phenyl-propylamino) benzoic acid (NPPB) on arrhythmias caused by myocardial ischemia reperfusion.
A total of 40 rabbits were divided into control, ischemia reperfusion, DIDS low-dose, DIDS high-dose, SITS low-dose, SITS high-dose, NPPB low-dose and NPPB high-dose groups. Myocardial ischemia reperfusion model was established by ligation of anterior descending coronary artery. And standard limb lead II of electrocardiogram (ECG) was continuously monitored during the experimental process. Then comparisons of heart rate, ECG P wave, R wave, T wave, ST segment changes and arrhythmias score were made between the above groups.
During 30-minute ischemia, compared with the control group, all other groups showed significantly decreased heart rate ((199.8 ± 4.0) - (253.6 ± 2.1) vs (267.0 ± 3.4), all P < 0.01), elevated ECG P wave ((0.216 ± 0.019) - (0.356 ± 0.024) vs (0.186 ± 0.019), all P < 0.01), R wave ((0.564 ± 0.017) - (1.138 ± 0.048) vs (0.506 ± 0.018), all P < 0.01), T wave ((0.542 ± 0.013) - (0.856 ± 0.045) vs (0.278 ± 0.015), all P < 0.01) and ST segment ((0.326 ± 0.027) - (0.668 ± 0.054) vs (0.024 ± 0.023), all P < 0.01) and increased arrhythmia score ((1.4 ± 0.5) - (4.6 ± 0.5) vs (0.4 ± 0.5), all P < 0.01). Compared with the ischemia reperfusion group, the above indices significantly improved in the intervention groups (heart rate: (214.8 ± 3.4) - (246.8 ± 4.0) vs (199.8 ± 4.0), all P < 0.01; P wave: (0.216 ± 0.019) - (0.316 ± 0.011) vs (0.356 ± 0.024), all P < 0.01; R wave: (0.564 ± 0.017) - (0.980 ± 0.035) vs (1.138 ± 0.048), all P < 0.01; T wave: (0.542 ± 0.013) - (0.792 ± 0.026) vs (0.856 ± 0.045), all P < 0.01; ST segment: (0.326 ± 0.027) - (0.596 ± 0.018) vs (0.668 ± 0.054), all P < 0.01; arrhythmia score: (1.4 ± 0.5) - (3.8 ± 0.4) vs (4.6 ± 0.5), all P < 0.01). Among which, the DIDS group was the best, followed by the SITS group and then the NPPB group. And the high-dose subgroups were better than those of the low-dose subgroups. During 60-minute reperfusion, the decreased heart rate upswing significantly in each group and the elevated P wave, R wave, T wave and ST segment fell back gradually. The DIDS group showed the most obvious amplitude change, followed by the SITS group and then the NPPB group. And the high-dose subgroups were better than those of the low-dose subgroups. The arrhythmia score during reperfusion showed the same trend.
Chloride ion channel is involved in the generation of myocardial ischemia reperfusion arrhythmia.Early application of chloride ion channel blockers DIDS, SITS and NPPB may improve the ECG manifestations and reduce the degree of reperfusion arrhythmia.
探讨氯离子通道及其阻滞剂4,4'-二异硫氰基芪-2,2'-二磺酸(DIDS)、氰基芪-2,2'-二磺酸(SITS)和5-硝基-2-(3-苯基丙基氨基)苯甲酸(NPPB)对心肌缺血再灌注所致心律失常的影响。
将40只家兔分为对照组、缺血再灌注组、DIDS低剂量组、DIDS高剂量组、SITS低剂量组、SITS高剂量组、NPPB低剂量组和NPPB高剂量组。采用结扎冠状动脉前降支的方法建立心肌缺血再灌注模型。实验过程中持续监测标准肢体导联II心电图(ECG)。然后比较上述各组的心率、ECG P波、R波、T波、ST段变化及心律失常评分。
在30分钟缺血期间,与对照组相比,其他各组心率均显著降低((199.8±4.0)-(253.6±2.1) vs (267.0±3.4),P均<0.01),ECG P波升高((0.216±0.019)-(0.356±0.024) vs (0.186±0.019),P均<0.01),R波升高((0.564±0.017)-(1.138±0.048) vs (0.506±0.018),P均<0.01),T波升高((0.542±0.013)-(0.856±0.045) vs (0.278±0.015),P均<0.01),ST段升高((0.326±0.027)-(0.668±0.054) vs (0.024±0.023),P均<0.01),心律失常评分增加((1.4±0.5)-(4.6±0.5) vs (0.4±0.5),P均<0.01)。与缺血再灌注组相比,干预组上述指标均显著改善(心率:(214.8±3.4)-(246.8±4.0) vs (199.8±4.0),P均<0.01;P波:(0.216±0.019)-(0.316±0.011) vs (0.356±0.024),P均<0.01;R波:(0.564±0.017)-(0.980±0.035) vs (1.138±0.048),P均<0.01;T波:(0.542±0.013)-(0.792±0.026) vs (0.856±0.045),P均<0.01;ST段:(0.326±0.027)-(0.596±0.018) vs (0.668±0.054),P均<0.01;心律失常评分:(1.4±0.5)-(3.8±0.4) vs (4.6±0.5),P均<0.01)。其中,DIDS组效果最佳,其次为SITS组,然后是NPPB组。且高剂量亚组优于低剂量亚组。在60分钟再灌注期间,各组心率下降幅度明显增加,升高的P波、R波、T波和ST段逐渐回落。DIDS组变化幅度最明显,其次为SITS组,然后是NPPB组。且高剂量亚组优于低剂量亚组。再灌注期间心律失常评分呈现相同趋势。
氯离子通道参与心肌缺血再灌注心律失常的发生。早期应用氯离子通道阻滞剂DIDS、SITS和NPPB可能改善ECG表现并降低再灌注心律失常的程度。