Lee Soo Yong, Jang Young Ho, Lee Mi Young, Hwang Jongmin, Lee Sang Hyun, Chon Min Ku, Hwang Sun Ae, Kim Jeong Su, Park Yong Hyun, Chun Kook Jin, Kim June Hong
Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Institute of Cancer Rehabilitation and Convalescence, Yoonsung Hospital, Cheongdo, Korea.
Korean Circ J. 2014 Nov;44(6):423-8. doi: 10.4070/kcj.2014.44.6.423. Epub 2014 Nov 25.
We investigated the effects of commonly used contrast media (CM) on myocardial ischemia-reperfusion injury in isolated rat hearts.
Isolated rat hearts were subjected to 30 minutes of regional ischemia and 2 hours of reperfusion. The following CM (1 mL/1 L Krebs-Henseleit buffer) were randomly perfused for 15 minutes beginning 5 minutes before reperfusion and ending 10 minutes after reperfusion: iohexol (n=8), iopromide (n=8), ioversol (n=8), iomeprol (n=8), iopamidol (n=7), ioxaglate (n=8), and iodixanol (n=7). The effects of a direct bolus injection of undiluted iohexol, iopromide, or ioxaglate (each n=6) via the aortic root immediately prior to reperfusion were also evaluated. The area of necrosis, expressed as the percentage of the area at risk (AN/AR), and cardiodynamic variables were measured.
The AN/AR of the control and experimental groups in the order described in methods was 33.7±6.4%, 30.3±7.4%, 34.7±12.6%, 29.2±10.2%, 20.9±7.6%, 22.6±8.7%, 18.8±7.9%, and 19.9±11.4%, respectively. Groups that received iomeprol and ioxaglate exhibited significantly decreased AN/AR values compared to those of control hearts (p=0.042 and p=0.013). No significant differences in the AN/AR were observed between control hearts and the groups injected with a single bolus of CM. No significant hemodynamic changes were noted after reperfusion among the groups.
The overall effects of the CM on coronary reperfusion were not deleterious, and better effects were noted in two CM groups. However, it is unclear whether this result was attributed to a specific physiochemical property of the CM.
我们研究了常用造影剂（CM）对离体大鼠心脏心肌缺血再灌注损伤的影响。
将离体大鼠心脏进行30分钟的局部缺血和2小时的再灌注。在再灌注前5分钟开始并在再灌注后10分钟结束，随机灌注以下造影剂（1 mL/1 L Krebs - Henseleit缓冲液）15分钟：碘海醇（n = 8）、碘普罗胺（n = 8）、碘佛醇（n = 8）、碘美普尔（n = 8）、碘帕醇（n = 7）、碘克沙醇（n = 8）和碘克酸（n = 8）。还评估了在再灌注前经主动脉根部直接推注未稀释的碘海醇、碘普罗胺或碘克沙醇（每组n = 6）的效果。测量坏死面积，以危险区域面积的百分比（AN/AR）表示，并测量心脏动力学变量。
按照方法中所述顺序，对照组和实验组的AN/AR分别为33.7±6.4%、30.3±7.4%、34.7±12.6%、29.2±10.2%、20.9±7.6%、22.6±8.7%、18.8±7.9%和19.9±11.4%。接受碘美普尔和碘克沙醇的组与对照心脏相比，AN/AR值显著降低（p = 0.042和p = 0.013）。在对照心脏与单次推注造影剂的组之间，未观察到AN/AR有显著差异。各组再灌注后未观察到显著的血流动力学变化。
造影剂对冠状动脉再灌注的总体影响并非有害，并且在两个造影剂组中观察到了更好的效果。然而，尚不清楚该结果是否归因于造影剂的特定物理化学性质。
