Illes R W, Silverman N A, Krukenkamp I B, del Nido P J, Levitsky S
Department of Surgery, University of Illinois College of Medicine, Chicago.
Circulation. 1989 Nov;80(5 Pt 2):III30-5.
Limitation of oxygen free-radical injury was assessed in canine hearts by sonomicrometrically quantifying regional stroke work (RSW) in areas of myocardium perfused by the left anterior descending (LAD) and left circumflex (LCX) arteries. Volume loading of the left ventricle was performed on modified right-heart bypass before and 30 minutes after 20 minutes of LAD occlusion followed by 60 minutes of global cardioplegic arrest with either blood cardioplegia (group 1), blood cardioplegia with adjuvant deferoxamine (500 mg/l) plus 100 mg infused into the aortic root for 5 minutes after unclamping (group 2), or blood cardioplegia with adjuvant deferoxamine (600 mg/l) with unmodified reperfusion (group 3). Surgical revascularization was modeled by reopening the LAD with the first cardioplegia reinfusion. The slope of the RSW versus preload relation (a load-independent index of contractility) was decreased by a mean amount of 44% in the LAD region of group 1 hearts but was preserved in group 2 and 3 hearts. The slope of the LCX region was preserved in all groups. The use of adjuvant deferoxamine in this model of early surgical reperfusion eliminates measurable postischemic stunning.
通过超声心动图测量左前降支（LAD）和左旋支（LCX）动脉灌注区域的局部搏功（RSW），评估犬心脏中氧自由基损伤的局限性。在LAD闭塞20分钟后，于改良右心旁路循环下进行左心室容量负荷，随后进行60分钟的全心停搏，分别采用血液停搏液（第1组）、血液停搏液加辅助去铁胺（500mg/L）并在松开钳夹后向主动脉根部注入100mg持续5分钟（第2组）或血液停搏液加辅助去铁胺（600mg/L）且不进行改良再灌注（第3组）。首次停搏液再灌注时重新开放LAD模拟外科血管重建。第1组心脏LAD区域RSW与前负荷关系的斜率（收缩性的负荷独立指标）平均降低44%，而第2组和第3组心脏中该斜率得以保留。所有组中LCX区域的斜率均得以保留。在此早期外科再灌注模型中使用辅助去铁胺可消除可测量的缺血后心肌顿抑。
