Wang Qiang, Li Rui-Ping, Xue Fu-Shan, Wang Shi-Yu, Cui Xin-Long, Cheng Yi, Liu Gao-Pu, Liao Xu
Department of Anesthesiology, Peking University People's Hospital, Beijing, China,
Inflamm Res. 2014 Dec;63(12):987-99. doi: 10.1007/s00011-014-0775-8. Epub 2014 Oct 8.
To determine the optimal intervention time of the vagal stimulation (VS) attenuating myocardial ischemia/reperfusion injury (IRI).
One hundred and twenty male SD rats were randomly allocated into six groups: sham group, IRI group, the VS performed at 15 min of ischemia (VSI15) group, the VS performed immediately before reperfusion (VSR0) group, the VS performed at 30 min of reperfusion (VSR30) group, and the VS performed at 60 min of reperfusion (VSR60) group. Rats in each group were further allocated into subgroups A and B. In each group, the hemodynamics and ventricular arrhythmias were continuously observed. In the subgroup A, serum inflammatory cytokine levels were tested, and infarct size was assessed. In the subgroup B, myocardial inflammatory cytokine levels in both ischemic and non-ischemic regions were assayed.
As compared to the IRI, VSR0, VSR30 and VSR60 groups, infarct size, serum HMGB-1 and ICAM-1 levels at 120 min of reperfusion, myocardial HMGB-1, IL-1 and IL-6 levels in non-ischemic region, myocardial ICAM-1 level in ischemic region were all significantly decreased in the VSI15 group. Compared with the IRI group, myocardial IL-10 levels in both ischemic and non-ischemic regions were significantly increased in the VSI15 group. Compared to the IRI, VSR0, VSR30 and VSR60 groups, incidence and score of ventricular arrhythmia during initial reperfusion were significantly decreased in the VSI15 group.
The VS performed at 15 min of ischemia provides the best protection against myocardial IRI. Also, early modulation on inflammatory responses caused by myocardial IRI may contribute to this best cardioprotection.
确定迷走神经刺激(VS)减轻心肌缺血/再灌注损伤(IRI)的最佳干预时间。
将120只雄性SD大鼠随机分为6组:假手术组、IRI组、缺血15分钟时进行VS的组(VSI15组)、再灌注前即刻进行VS的组(VSR0组)、再灌注30分钟时进行VS的组(VSR30组)和再灌注60分钟时进行VS的组(VSR60组)。每组大鼠再进一步分为A、B亚组。连续观察每组大鼠的血流动力学和室性心律失常情况。A亚组检测血清炎性细胞因子水平并评估梗死面积。B亚组检测缺血和非缺血区域的心肌炎性细胞因子水平。
与IRI组相比,VSR0组、VSR30组和VSR60组,VSI15组再灌注120分钟时的梗死面积、血清高迁移率族蛋白B1(HMGB-1)和细胞间黏附分子-1(ICAM-1)水平、非缺血区域心肌HMGB-1、白细胞介素-1(IL-1)和IL-6水平、缺血区域心肌ICAM-1水平均显著降低。与IRI组相比,VSI15组缺血和非缺血区域的心肌IL-10水平均显著升高。与IRI组、VSR0组、VSR30组和VSR60组相比,VSI15组再灌注初期室性心律失常的发生率和评分均显著降低。
缺血15分钟时进行VS对心肌IRI具有最佳保护作用。此外,对心肌IRI引起的炎性反应进行早期调节可能有助于这种最佳的心脏保护作用。