Wahr J A, Childs K F, Bolling S F
Department of Anesthesiology, University of Michigan, Ann Arbor 48109-0048.
J Cardiothorac Vasc Anesth. 1994 Apr;8(2):192-7. doi: 10.1016/1053-0770(94)90061-2.
This study was undertaken to determine the effect of dichloroacetate (DCA) on myocardial functional and metabolic recovery following global ischemia. Sixteen isolated rabbit hearts were subjected to 120 minutes of mildly hypothermic (34 degrees C) cardioplegic arrest with multi-dose, modified St. Thomas' cardioplegia. Following ischemia, hearts were reperfused with either a physiologic salt solution (PSS) as controls, (CON, N = 10), or PSS containing DCA (DCA, N = 6) at a concentration of 1 mmol/L. Functional and metabolic indices were determined at baseline and at 15, 30, and 45 minutes of reperfusion. Results were analyzed using analysis of variance (ANOVA, Sheffe F test) and significance was defined as P < 0.05. Functional recovery was significantly better in hearts reperfused with DCA. Developed pressure (DP) recovered to 62 +/- 4% of baseline in DCA hearts, compared to 37 +/- 8% in CON hearts. Recovery of dP/dt was also improved in DCA versus CON hearts (67 +/- 5 v 43 +/- 10%). Coronary blood flow was not different between groups either at baseline or during reperfusion, but myocardial oxygen consumption (MVO2) was increased in the DCA versus CON hearts (71 +/- 10% of baseline, v 51 +/- 19%). Diastolic compliance during reperfusion was improved in those hearts receiving DCA, as was myocardial mechanical use efficiency (DP/MVO2). Correction of myocardial tissue pH to baseline values was similar in both groups, indicating that the beneficial effect on functional recovery seen with DCA was not solely related to amelioration of acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在确定二氯乙酸（DCA）对全脑缺血后心肌功能和代谢恢复的影响。16个离体兔心接受多剂量改良圣托马斯停搏液，在轻度低温（34℃）下进行120分钟心脏停搏。缺血后，心脏分别用生理盐溶液（PSS）作为对照（CON，n = 10）或含1 mmol/L DCA的PSS（DCA，n = 6）进行再灌注。在基线以及再灌注15、30和45分钟时测定功能和代谢指标。结果采用方差分析（ANOVA，谢弗F检验）进行分析，显著性定义为P < 0.05。用DCA再灌注的心脏功能恢复明显更好。DCA组心脏的舒张末期压力（DP）恢复到基线的62±4%，而对照组心脏为37±8%。与对照组相比，DCA组心脏中dp/dt的恢复也有所改善（67±5对43±10%）。两组在基线或再灌注期间冠状动脉血流量均无差异，但DCA组心脏的心肌耗氧量（MVO2）高于对照组（为基线的71±10%，对51±19%）。接受DCA的心脏在再灌注期间的舒张顺应性得到改善，心肌机械利用效率（DP/MVO2）也是如此。两组心肌组织pH值恢复到基线值的情况相似，这表明DCA对功能恢复的有益作用并非仅与酸中毒的改善有关。（摘要截短于250字）
