Songur C Murat, Songur Merve Ozenen, Kocabeyoglu Sinan Sabit, Basgut Bilgen
Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital Ankara, Turkey.
Department of Pharmacology, Faculty of Pharmacy, Gazi University, Ankara, Turkey.
Heart Surg Forum. 2014 Oct 1;17(5):E263-8. doi: 10.1532/HSF98.2014400.
We sought to investigate the effects of the angiotension II receptor blocker candesartan on ischemia-reperfusion injury using a cardioplegia arrested isolated rat heart model.
Ischemia-reperfusion injury was induced in isolated rat hearts with 40 minutes of global ischemia followed by a 30-minute reperfusion protocol. Throughout the experiment, constant pressure perfusion was achieved using a Langendorff apparatus. Cardioplegic solution alone, and in combination with candesartan, was administered before ischemia and 20 minutes after ischemia. Post-ischemic recovery of contractile function, left ventricular developed pressure, left ventricular end-diastolic pressure and contraction and relaxation rates were evaluated.
In the control group, left ventricular developed pressure, rate pressure product, contraction and relaxation rates and coronary flow significantly decreased but coronary resistance increased following reperfusion. With the administration of candesartan alone, parameters did not differ compared to controls. Contractile parameters improved in the group that received candesartan in combination with the cardioplegia compared to the group that received cardioplegia alone; however, the difference between these two groups was insignificant.
In this study, the addition of candesartan to a cardioplegic arrest protocol routinely performed during cardiac surgery did not provide a significant advantage in protection against ischemia-reperfusion injury compared with the administration of cardioplegic solution alone.
我们试图使用停搏的离体大鼠心脏模型,研究血管紧张素II受体阻滞剂坎地沙坦对缺血再灌注损伤的影响。
通过40分钟全心缺血随后30分钟再灌注方案,在离体大鼠心脏中诱导缺血再灌注损伤。在整个实验过程中,使用Langendorff装置实现恒压灌注。在缺血前和缺血后20分钟,单独给予心脏停搏液以及与坎地沙坦联合给予心脏停搏液。评估缺血后收缩功能、左心室舒张末压、左心室舒张末压力以及收缩和舒张速率的恢复情况。
在对照组中,再灌注后左心室舒张末压、心率血压乘积、收缩和舒张速率以及冠脉流量显著降低,但冠脉阻力增加。单独给予坎地沙坦时,各项参数与对照组相比无差异。与单独接受心脏停搏液的组相比,联合心脏停搏液接受坎地沙坦的组收缩参数有所改善;然而,这两组之间的差异不显著。
在本研究中,与单独给予心脏停搏液相比,在心脏手术期间常规实施的心脏停搏方案中添加坎地沙坦,在预防缺血再灌注损伤方面未提供显著优势。