Department of Anesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650032, China; Department of Anesthesiology, Yan'an Hospital of Kunming City, Kunming Medical University, Kunming, Yunnan Province, 650051, China.
Department of Anesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650032, China.
Biomed Pharmacother. 2019 Jun;114:108837. doi: 10.1016/j.biopha.2019.108837. Epub 2019 Apr 6.
Dexmedetomidine preconditioning (DP) can mimic pharmacological preconditioning and induce cardiac protection. There are controversies on the roles of coronary endothelia in cardioprotection of dexmedetomidine. Herein, we tested the hypothesis that protection of dexmedetomidine is not endothelial dependent in heart against myocardial ischemia/reperfusion (I/R) injury.
Langendorff-perfused rat hearts were pretreated by 60 mM of potassium to produce endothelial dysfunction (ED), then medicated with dexmedetomidine, and subsequently subjected to 30 min of global ischemia followed by 60 min of reperfusion. To investigate the cardioprotective effect of dexmedetomidine in heart with ED, isolated rat hearts were randomly divided into the following six groups: sham, I/R, DP, ED, ED + I/R, and ED + DP + I/R. Heart rates, left ventricular function, and coronary perfusion pressure were assessed for each heart. Infarct size was evaluated by triphenyltetrazolium chloride staining. High-sensitivity cardiac troponin T (hs-cTNT) of coronary flow perfusion was determined.
After the isolated hearts with pretreatment of 60 mM of potassium chloride, diastolic function of coronary endothelia in performance of response to histamine was significantly decreased (P < 0.05). DP attenuated I/R-induced infarct size of the left ventricle (P < 0.05) and decreased hs-cTNT (P < 0.05). Additionally, left ventricular developed pressure, +dp/dt, and -dp/dt were elevated in rat hearts pretreated with dexmedetomidine. Furthermore, dexmedetomidine-mediated cardiac protection against I/R injury was still remained in isolated hearts with coronary ED.
Continuous perfusion of 60 mM of potassium for 10 min can produce coronary ED in isolated rat hearts. Dexmedetomidine maintains its protective function against I/R injury in heart with coronary ED. Myocardial protection of dexmedetomidine is non-endothelial function dependent in alleviating I/R injury.
右美托咪定预处理(DP)可以模拟药理学预处理,诱导心脏保护。在右美托咪啶诱导的心脏保护作用中,冠状动脉内皮的作用存在争议。在此,我们通过实验验证了假设,即右美托咪定对心肌缺血/再灌注(I/R)损伤的心脏保护作用不依赖于内皮细胞。
Langendorff 灌注大鼠心脏用 60mM 钾预处理产生内皮功能障碍(ED),然后用右美托咪定处理,随后进行 30 分钟的整体缺血,再灌注 60 分钟。为了研究 ED 心脏中右美托咪定的心脏保护作用,将分离的大鼠心脏随机分为以下六组:假手术组、I/R 组、DP 组、ED 组、ED+I/R 组和 ED+DP+I/R 组。评估每只心脏的心率、左心室功能和冠状动脉灌注压。通过氯化三苯基四氮唑染色评估梗死面积。测定冠状动脉灌注时的高敏心肌肌钙蛋白 T(hs-cTNT)。
用 60mM 氯化钾预处理后,离体心脏的冠状动脉内皮对组胺反应的舒张功能明显降低(P<0.05)。DP 可减轻 I/R 引起的左心室梗死面积(P<0.05)和降低 hs-cTNT(P<0.05)。此外,用右美托咪定预处理的大鼠心脏左心室收缩压、+dp/dt 和-dp/dt 升高。此外,右美托咪定介导的心脏对 I/R 损伤的保护作用在冠状动脉 ED 的离体心脏中仍然存在。
连续灌注 10 分钟 60mM 钾可在离体大鼠心脏中产生冠状动脉 ED。右美托咪定在冠状动脉 ED 的心脏中保持其对 I/R 损伤的保护作用。右美托咪定减轻 I/R 损伤的心肌保护作用不依赖于内皮功能。