Váczi G, Aranyosi J, Békássy S M
Scand J Thorac Cardiovasc Surg. 1984;18(3):203-7. doi: 10.3109/14017438409109892.
Changes in serum cyclic AMP and GMP concentrations were studied in 14 patients undergoing open-heart surgery with cold cardioplegia. Blood samples were taken on total bypass from the radial artery and from the coronary sinus before aortic cross-clamping and 1 and 9 min after declamping. The samples were analyzed for cyclic nucleotides. The cAMP levels showed no pronounced change in the arterial samples, but were significantly increased in the coronary sinus samples after declamping of the aorta. The cGMP values showed the same trend of change in the arterial and the coronary sinus samples, viz. significant fall after aortic release, and after 9 min an increase. The cAMP/cGMP ratio after clamp removal showed pronounced increase in the first minute and some reduction at 9 min. All the changes were statistically significant. Beating recommenced spontaneously in seven hearts. The cAMP levels were lower in this group than in the patients without spontaneous recovery. The outset cGMP levels and the cAMP/cGMP ratio were higher in the latter group. Absence of increase in the cGMP level may be due to effectiveness of cardioplegia in reducing the energy requirements of the ischemic myocardium. The study indicates that hearts without spontaneous recovery of beating react more sensitively to hypoxia and have to use up more of their energy resources for restoration of function.
对14例接受心脏直视手术并采用冷心脏停搏液的患者血清环磷酸腺苷（cAMP）和环磷酸鸟苷（cGMP）浓度的变化进行了研究。在体外循环期间，于主动脉阻断前、阻断后1分钟和9分钟时，从桡动脉和冠状窦采集血样。对血样进行环核苷酸分析。动脉血样中的cAMP水平无明显变化，但主动脉开放后冠状窦血样中的cAMP水平显著升高。动脉血样和冠状窦血样中的cGMP值呈现相同的变化趋势，即主动脉开放后显著下降，9分钟后升高。解除阻断后1分钟时，cAMP/cGMP比值显著升高，9分钟时有所下降。所有这些变化均具有统计学意义。7例心脏自动恢复跳动。该组患者的cAMP水平低于未自动恢复的患者。后一组患者的初始cGMP水平和cAMP/cGMP比值较高。cGMP水平未升高可能是由于心脏停搏液在降低缺血心肌能量需求方面的有效性。该研究表明，未自动恢复跳动的心脏对缺氧反应更敏感，并且为恢复功能不得不消耗更多的能量资源。
