Clark R E, Christlieb I Y, Henry P D, Fischer A E, Nora J D, Williamson J R, Sobel B E
Am J Cardiol. 1979 Oct 22;44(5):825-31. doi: 10.1016/0002-9149(79)90204-2.
The effectiveness of the calcium antagonist nifedipine in preserving postischemic myocardial function and structural integrity was experimentally demonstrated in isolated rabbit hearts, in conscious dogs subjected to myocardial infarction, in open chest anesthetized dogs with normothermic regional ischemia induced for 1 to 2 hours and in dogs undergoing hypothermic global ischemia for 2 hours followed by 2 hours of reperfusion. Nifedipine had a beneficial effect on postischemic myocardial stiffness and mitochondrial calcium accumulation, which were correlated. Administration of nifedipine at the onset of myocardial infarction increased blood flow to ischemic zones of myocardial infarction and resulted in less loss of creatine kinase. It reduced by two- to three-fold the volume of the ischemia-reperfusion injury induced by left anterior descending coronary arterial occlusion and release and preserved indexes of hemodynamic function. Nifedipine was found effective in protecting myocardial performance and structure after 2 hours of global ischemia during hypothermic cardiopulmonary bypass. It is suggested that this agent may be useful as an adjunct to cold cardioplegia in man for enhanced myocardial protection during cardiac surgery.
钙拮抗剂硝苯地平在保护缺血后心肌功能和结构完整性方面的有效性，已在离体兔心、心肌梗死清醒犬、开胸麻醉且诱导常温局部缺血1至2小时的犬以及经历低温全心缺血2小时后再灌注2小时的犬身上得到实验证实。硝苯地平对缺血后心肌僵硬度和线粒体钙蓄积有有益作用，二者具有相关性。在心肌梗死发作时给予硝苯地平可增加心肌梗死缺血区的血流量，并减少肌酸激酶的损失。它使左前降支冠状动脉闭塞和再通所诱导的缺血再灌注损伤体积减少两到三倍，并保留了血流动力学功能指标。研究发现，硝苯地平在低温体外循环期间全心缺血2小时后对保护心肌性能和结构有效。有人提出，这种药物在人类心脏手术中作为冷停搏液的辅助药物，可能有助于增强心肌保护作用。
