Farber N E, Gross G J
Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee 53226.
Am Heart J. 1989 Jul;118(1):17-24. doi: 10.1016/0002-8703(89)90066-5.
We have previously demonstrated that administration of the prostacyclin analogue iloprost improved postischemic functional recovery in reversibly injured ischemic-reperfused myocardium. The present study investigated the effects of administering an endogenous vasodilator prostanoid, prostaglandin E1 (PGE1), in the stunned myocardium (15 minutes of coronary artery occlusion and 3 hours of reperfusion) of anesthetized dogs. The percentage of regional myocardial segment shortening (%SS) after administration of PGE1 by two routes, intravenously (1 microgram/kg/min) or intraatrially (0.1 microgram/kg/min), to avoid pulmonary metabolism, 15 minutes before and throughout the period of occlusion, was compared to %SS in a control group treated with saline solution. Nearly equivalent reductions in mean arterial pressure during occlusion compared to pretreatment control (PTC) values were produced by intravenous (33%) or intraatrial (25%) PGE1. There was no difference in transmural myocardial blood flow (radioactive microsphere technique) in the ischemic region between the PGE1-treated and control groups at any time. Although there were no differences in %SS in the nonischemic region between groups throughout the experiment, postischemic recovery of segment function in the ischemic-reperfused area was significantly improved (p less than 0.05) at all times during reperfusion by intravenous PGE1 (%SS of PTC: 30 minutes = 65 +/- 8; 3 hours = 58 +/- 7) or intraatrial PGE1 (%SS of PTC: 30 minutes = 57 +/- 12; 3 hours = 50 +/- 4) compared to the control group (%SS of PTC: 30 minutes = 25 +/- 13; 3 hours = 10 +/- 13). Thus treatment with PGE1 attenuates postischemic contractile dysfunction in the stunned myocardium.2+ both.
我们之前已经证明,给予前列环素类似物伊洛前列素可改善可逆性损伤的缺血再灌注心肌的缺血后功能恢复。本研究调查了在麻醉犬的顿抑心肌(冠状动脉闭塞15分钟和再灌注3小时)中给予内源性血管扩张剂前列腺素类物质前列腺素E1(PGE1)的效果。通过静脉内(1微克/千克/分钟)或心房内(0.1微克/千克/分钟)两种途径给予PGE1,以避免肺部代谢,在闭塞前15分钟和整个闭塞期间,将其与用生理盐水治疗的对照组的局部心肌节段缩短百分比(%SS)进行比较。静脉内(33%)或心房内(25%)PGE1导致闭塞期间平均动脉压与预处理对照(PTC)值相比有近乎相同程度的降低。在任何时候,PGE1治疗组和对照组缺血区域的透壁心肌血流量(放射性微球技术)均无差异。尽管在整个实验过程中,各组非缺血区域的%SS没有差异,但在再灌注期间的所有时间,静脉内给予PGE1(PTC的%SS:30分钟 = 65 ± 8;3小时 = 58 ± 7)或心房内给予PGE1(PTC的%SS:30分钟 = 57 ± 12;3小时 = 50 ± 4)后,缺血再灌注区域节段功能的缺血后恢复与对照组(PTC的%SS:30分钟 = 25 ± 13;3小时 = 10 ± 13)相比均得到显著改善(p < 0.05)。因此,PGE1治疗可减轻顿抑心肌的缺血后收缩功能障碍。