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血小板活化因子诱导的心肌梗死后兔离体心脏的心肌功能障碍和冠状动脉收缩

Myocardial dysfunction and coronary vasoconstriction induced by platelet-activating factor in the post-infarcted rabbit isolated heart.

作者信息

Mickelson J K, Simpson P J, Lucchesi B R

机构信息

Department of Pharmacology, University of Michigan Medical School, Ann Arbor 48109.

出版信息

J Mol Cell Cardiol. 1988 Jun;20(6):547-61. doi: 10.1016/s0022-2828(88)80081-6.

Abstract

Myocardial injury was produced in separated groups of anesthetized rabbits by occlusion of the left circumflex coronary artery for 1 h followed by reperfusion for 2, 4, or 6 h after release of the occlusive ligature. The ischemically-injured and reperfused hearts subsequently were isolated and perfused using a modified Langendorff apparatus. Platelet-activating factor in the form of AGEPC (1-0-hexadecyl-2-acetyl-sn-glyceryl-phosphorylcholine), 40 nmol in 1 ml, was infused above the coronary ostia over 15 s. Thromboxane B2 (TxB2- and peptidoleukotrienes (LT) were measured in the lymphatic effluent from the heart. Noninfarcted hearts (isolated hearts and sham-operated animals) served as procedural controls and lyso-GEPC (1-0-hexa-decyl-2-0-lyso-sn-glyceryl-phosphorylcholine), 40 nmol in 1 ml, served as the agonist control. After the infusion of AGEPC in the infarcted hearts, coronary perfusion pressure and left ventricular end-diastolic pressure increased while left ventricular peak systolic pressure decreased. The observed changes coincided with TxB2 peak release at 1 min and LT peak release at 2 min. The longer post-ischemic reperfusion time was associated with increasingly greater changes in these parameters. In hearts isolated after 6 h of reperfusion, the functional changes and the appearance of TxB2 and LT in response to the administration of AGEPC reached a significant level (ANOVA) with respect to those base-line values and the values obtained with hearts from sham-operated animals. Minimal changes occurred in noninfarcted hearts or with the administration of the biologically inactive phospholipid, lyso-GEPC. Histologic evaluation of cardiac tissue showed a progressive time-dependent migratory increase of leukocytes from the intra- and perivascular areas toward the region of infarcted myocardium. Platelet aggregates were seen in the intravascular spaces. The data are consistent with the suggestion that the infiltrating leukocytes and platelets may serve as a source for the synthesis and release of TxB2 and LT in acutely infarcted hearts upon exposure to AGEPC. If it is possible for AGEPC to be synthesized and released from vascular endothelial or inflammatory cells leading to the formation of thromboxane A2 and LT from reperfused myocardium, then these substances may participate in increasing coronary artery resistance and in the development of myocardial dysfunction during the evolution of an acute myocardial infarction and especially during the phase of perfusion.

摘要

在单独的几组麻醉兔中,通过结扎左旋冠状动脉1小时,然后在松开结扎线后再灌注2、4或6小时来造成心肌损伤。随后,将缺血损伤并再灌注的心脏分离出来,使用改良的Langendorff装置进行灌注。以AGEPC(1-0-十六烷基-2-乙酰基-sn-甘油磷酸胆碱)形式存在的血小板活化因子,1ml中含40nmol,在15秒内注入冠状动脉口上方。在心脏的淋巴流出液中测量血栓素B2(TxB2)和肽白三烯(LT)。未梗死的心脏(分离的心脏和假手术动物)作为操作对照,1ml中含40nmol的溶血-GEPC(1-0-十六烷基-2-0-溶血-sn-甘油磷酸胆碱)作为激动剂对照。在梗死心脏中注入AGEPC后,冠状动脉灌注压和左心室舒张末期压力升高,而左心室收缩压峰值降低。观察到的变化与TxB2在1分钟时的峰值释放和LT在2分钟时的峰值释放同时发生。缺血后再灌注时间越长,这些参数的变化就越大。在再灌注6小时后分离的心脏中,与假手术动物心脏的基线值和所获得的值相比,给予AGEPC后功能变化以及TxB2和LT的出现达到了显著水平(方差分析)。在未梗死的心脏中或给予无生物活性的磷脂溶血-GEPC时,变化最小。心脏组织的组织学评估显示,白细胞从血管内和血管周围区域向梗死心肌区域的迁移呈时间依赖性逐渐增加。在血管内空间可见血小板聚集。这些数据与以下观点一致,即浸润的白细胞和血小板可能是急性梗死心脏在接触AGEPC后合成和释放TxB2和LT的来源。如果AGEPC有可能从血管内皮或炎症细胞合成并释放,导致再灌注心肌形成血栓素A2和LT,那么这些物质可能参与增加冠状动脉阻力以及在急性心肌梗死演变过程中,特别是在灌注阶段心肌功能障碍的发展。

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