Ferrari R, Boraso A, Condorelli E, De Giuli F, Pasini E, Cargnoni A, Agnoletti G, Ghielmi S
Cattedra di Cardiologia, Universita degli Studi di Brescia, Italy.
Z Kardiol. 1989;78 Suppl 5:1-11.
To establish if the administration of gallopamil, a derivative of verapamil, protects heart muscle against the deleterious effect of ischemia and subsequent reperfusion, rabbits were injected subcutaneously twice daily with 2 mg/kg of Gallopamil for 5-6 days. The hearts were isolated and perfused with aerobic Krebs-Henseleit buffer solution by the Langendorff method. The hearts were paced (180 b/min) and wall temperature was controlled. Ischemia was induced by reducing coronary flow from 25 ml/min to 1 ml/min for 90 min and then the hearts were reperfused for 30 min. At the end of either the ischemic period or reperfusion, the hearts were assayed for ATP, CP, and calcium. Others were homogenized, their mitochondria harvested and monitored for oxidative phosphorylating and ATP generating activity as well as calcium content and uptake. The mechanical function of the hearts and noradrenaline release was also measured. Hearts that were made ischemic gained calcium, their endogenous stores of ATP and CP were depleted, their mitochondria had reduced RCI and state 3 respiration and increased calcium concentrations. During reperfusion tissue and mitochondrial calcium was significantly increased, the capacity of mitochondria to use oxygen for state 3 respiration was further impaired and their ATP generating capacity reduced. Diastolic pressure increased and there was no recovery of developed pressure and important noradrenaline release. Pretreatment with gallopamil protected the mitochondria against the ischemically induced changes in RCI, state 3 respiration. There was also a less marked rise in tissue and mitochondrial calcium and a reduced increase of diastolic pressure. Gallopamil also diminished the effect of reperfusion on the calcium accumulating activity of mitochondria and on the decline in the ATP generating and oxygen utilizing capacity of the mitochondria. The tissue levels of ATP and CP were better maintained, and noradrenaline release was reduced, the systolic pressure generating capacity was enhanced by the treatment with gallopamil. These results are discussed in accordance with the hypothesis that this drug protects heart muscle against the deleterious effects of ischemia and reperfusion by ensuring that sufficient ATP remains available to maintain homeostasis with respect to calcium.
为确定维拉帕米衍生物加洛帕米的给药是否能保护心肌免受缺血及随后再灌注的有害影响,每天给家兔皮下注射2毫克/千克加洛帕米,持续5 - 6天,每日两次。通过Langendorff法将心脏分离,并用有氧的克雷布斯 - 亨塞尔特缓冲溶液灌注。使心脏起搏(180次/分钟)并控制壁温。通过将冠状动脉血流从25毫升/分钟降至1毫升/分钟诱导缺血90分钟,然后使心脏再灌注30分钟。在缺血期或再灌注结束时,检测心脏的三磷酸腺苷(ATP)、磷酸肌酸(CP)和钙含量。其他心脏被匀浆,收集其线粒体并监测氧化磷酸化和ATP生成活性以及钙含量和摄取情况。还测量了心脏的机械功能和去甲肾上腺素释放。发生缺血的心脏钙含量增加,其ATP和CP的内源性储备耗尽,线粒体的呼吸控制率(RCI)和状态3呼吸降低,钙浓度增加。在再灌注期间,组织和线粒体钙显著增加,线粒体利用氧气进行状态3呼吸的能力进一步受损,其ATP生成能力降低。舒张压升高,舒张期压力未恢复,去甲肾上腺素大量释放。加洛帕米预处理可保护线粒体免受缺血诱导的RCI、状态3呼吸变化的影响。组织和线粒体钙的升高也不太明显,舒张压的升高减少。加洛帕米还减弱了再灌注对线粒体钙积累活性以及线粒体ATP生成和氧气利用能力下降的影响。ATP和CP的组织水平得到更好的维持,去甲肾上腺素释放减少,加洛帕米治疗增强了收缩压生成能力。根据该药物通过确保有足够的ATP可用于维持钙稳态来保护心肌免受缺血和再灌注有害影响的假说,对这些结果进行了讨论。