Bolling S F, Bies L E, Gallagher K P, Bove E L
Section of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor 48109.
Ann Thorac Surg. 1989 Jun;47(6):809-15. doi: 10.1016/0003-4975(89)90008-8.
This study was undertaken to investigate whether adenosine administered during cardioplegic arrest could enhance myocardial protection and improve recovery of function after ischemia. Isolated perfused rabbit hearts were subjected to 120 minutes of hypothermic (32 degrees C) multidose cardioplegia-induced ischemia. Control hearts (n = 23) received modified St. Thomas's cardioplegia, and the remaining hearts received cardioplegia with either 100 microM (n = 11), 200 microM (n = 11), or 400 microM (n = 11) adenosine. After ischemia and 45 minutes of reperfusion, left ventricular contractility was superior in all groups of adenosine-treated hearts compared with control hearts. Furthermore, there was a significant incremental increase in functional recovery with increasing dose of adenosine. Postischemic diastolic stiffness was significantly better in all adenosine groups compared with controls. No differences were noted in coronary flow or myocardial water content between adenosinetreated and control hearts. These data demonstrate that adenosine administered in these concentrations provides myocardial protection and improved recovery of both systolic and diastolic function after global ischemia, presumably metabolically by reducing depletion of adenosine triphosphate or enhancing repletion of adenosine triphosphate and enabling improved postischemic recovery.
本研究旨在探讨在心脏停搏期间给予腺苷是否能增强心肌保护作用并改善缺血后心功能的恢复。将离体灌注兔心置于低温（32℃）多剂量心脏停搏诱导的缺血状态120分钟。对照组心脏（n = 23）接受改良圣托马斯心脏停搏液，其余心脏接受添加100微摩尔（n = 11）、200微摩尔（n = 11）或400微摩尔（n = 11）腺苷的心脏停搏液。缺血及45分钟再灌注后，与对照组心脏相比，所有接受腺苷治疗的心脏组左心室收缩性均更优。此外，随着腺苷剂量增加，功能恢复有显著的增量改善。与对照组相比，所有腺苷组缺血后舒张期僵硬度均显著更好。接受腺苷治疗的心脏与对照心脏在冠状动脉血流或心肌含水量方面未观察到差异。这些数据表明，以这些浓度给予的腺苷可提供心肌保护作用，并改善全心缺血后收缩和舒张功能的恢复，推测是通过代谢方式减少三磷酸腺苷的消耗或增强三磷酸腺苷的补充，从而实现更好的缺血后恢复。
