Kempsford R D, Murashita T, Hearse D J
Rayne Institute, St. Thomas' Hospital, London, United Kingdom.
Am J Physiol. 1990 Sep;259(3 Pt 2):H879-88. doi: 10.1152/ajpheart.1990.259.3.H879.
The potential benefit of transient hypothermic reperfusion of the ischemic myocardium was investigated in isolated working rat hearts (n = 6/group) subjected to 25 min of global ischemia at 37 degrees C. Hearts were reperfused in the Langendorff mode at 5, 10, 20, 30, or 37 degrees C for 10 min plus 5 min at 37 degrees C before assessment of functional recovery (working mode). Compared with normothermic reperfusion (recovery of cardiac output = 42.3 +/- 6.1%), transient hypothermia failed to improve the recovery of cardiac output, which was 47.9 +/- 12.7 (P = NS), 54.3 +/- 11.5 (P = NS), 25.3 +/- 2.7 (P = NS), and 6.4 +/- 3.8% (P less than 0.05) in the 30, 20, 10, and 5 degrees C groups, respectively. Reduced recovery in the 5 degrees C group was reflected in increased creatine kinase leakage from 0.26 +/- 0.04 IU.ml-1.g dry wt-1 (37 degrees C reperfusion) to 0.62 +/- 0.12 IU. ml-1.g dry wt-1 (5 degrees C reperfusion; P less than 0.05). Brief periods (3 x 1 min) of hypothermic (5 degrees C) perfusion during normothermic Langendorff reperfusion (15 min) also reduced recovery of cardiac output to 12.1 +/- 7.2% (P less than 0.01). In additional studies, hearts were subjected to a 2-min preischemic infusion with the St. Thomas' Hospital cardioplegic solution before either 25 or 35 min of normothermic ischemia and reperfusion with transient hypothermia at 5, 10, 20, or 30 degrees C. Once again hypothermic reperfusion failed to improve recovery but detrimental effects were not observed in the 5 degrees C group. These results indicate no beneficial effect of transient hypothermic reperfusion on recovery of function measured following global normothermic ischemia.
在37℃下对离体工作大鼠心脏(每组n = 6)进行25分钟全心缺血处理,研究缺血心肌短暂低温再灌注的潜在益处。心脏在Langendorff模式下于5、10、20、30或37℃再灌注10分钟,然后在37℃再灌注5分钟,之后评估功能恢复情况(工作模式)。与常温再灌注(心输出量恢复率 = 42.3±6.1%)相比,短暂低温未能改善心输出量的恢复,30℃、20℃、10℃和5℃组的心输出量恢复率分别为47.9±12.7(P = 无显著性差异)、54.3±11.5(P = 无显著性差异)、25.3±2.7(P = 无显著性差异)和6.4±3.8%(P<0.05)。5℃组恢复率降低表现为肌酸激酶漏出增加,从0.26±0.04 IU·ml⁻¹·g干重⁻¹(37℃再灌注)增至0.62±0.12 IU·ml⁻¹·g干重⁻¹(5℃再灌注;P<0.05)。在常温Langendorff再灌注(15分钟)期间进行短暂(3×1分钟)低温(5℃)灌注也会使心输出量恢复率降至12.1±7.2%(P<0.01)。在另外的研究中,心脏在25或35分钟常温缺血及5、10、20或30℃短暂低温再灌注之前,先用圣托马斯医院心脏停搏液进行2分钟缺血前灌注。低温再灌注再次未能改善恢复情况,但5℃组未观察到有害影响。这些结果表明,短暂低温再灌注对全心常温缺血后测量的功能恢复没有有益作用。