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[硝酸甘油和硝苯地平对短暂反复缺血所致心肌顿抑的影响]

[Effects of nitroglycerin and nifedipine on stunned myocardium due to brief repeated ischemias].

作者信息

Pomar Domingo F, Cosín Aguilar J, Hernándiz A, Portoles M, Pallarés V, Andrés F

机构信息

Unidad de Cardiocirculatorio, Hospital Universitario La Fe. Valencia.

出版信息

Rev Esp Cardiol. 1996 May;49(5):360-71.

PMID:8744391
Abstract

OBJECTIVE

To analyze whether nitroglycerin and nifedipine can reduce myocardial stunning due to very brief, repeated coronary ischemias.

MATERIAL AND METHODS

In 33 anaesthetized and open chest dogs, the lengthening and shortening fractions were analyzed with ultrasonic crystals in the ischemic and control myocardial areas. Twenty repeated coronary occlusions of 2 minutes each, with a recovery time of 3 minutes between each occlusion, were induced. At the beginning of the experiment, nitroglycerin (0.3 mg i.v. and 80 micrograms/kg/min perfusion) was administered in series A (n = 8), nifedipine (5 mu/kg i.v. and 1 microgram/kg/min perfusion) in series B (n = 9). The results were compared with control results (n = 16) without drugs.

RESULTS

Changes in the shortening fraction of the ischemic area during coronary occlusions were similar in all three series; after the last occlusion the shortening fraction in the control series was -14.9% with respect to basal values, -14.6% in series A and -16.6% in series B. Sixty minutes after the last ischemia, the shortening fraction impairment in respect to the basal values was larger in the control series (-18.9%) and in series A (-16.9%). In series B there was recovery (-13.5%) (p < 0.05 vs control series).

CONCLUSIONS

Our study indicates that nitroglycerin does not seem to have cardioprotective effects against brief, repeated ischemia. However, nifedipine decreases postischemic dysfunction due to this model of ischemia, probably by avoiding the intracellular Ca overload produced during cardiac ischemia.

摘要

目的

分析硝酸甘油和硝苯地平是否能减轻因非常短暂、反复的冠状动脉缺血所致的心肌顿抑。

材料与方法

在33只麻醉开胸犬中,用超声晶体分析缺血心肌区域和对照心肌区域的伸长分数和缩短分数。诱导20次每次2分钟的反复冠状动脉闭塞,每次闭塞之间有3分钟的恢复时间。实验开始时,A组(n = 8)静脉注射硝酸甘油(0.3 mg)并以80 μg/kg/min灌注,B组(n = 9)静脉注射硝苯地平(5 μg/kg)并以1 μg/kg/min灌注。将结果与未用药的对照结果(n = 16)进行比较。

结果

在所有三个系列中,冠状动脉闭塞期间缺血区域缩短分数的变化相似;在最后一次闭塞后,对照系列中相对于基础值的缩短分数为-14.9%,A组为-14.6%,B组为-16.6%。在最后一次缺血后60分钟,相对于基础值,对照系列(-18.9%)和A组(-16.9%)的缩短分数损害更大。B组有恢复(-13.5%)(与对照系列相比,p < 0.05)。

结论

我们的研究表明,硝酸甘油似乎对短暂、反复的缺血没有心脏保护作用。然而,硝苯地平可减轻因这种缺血模型所致的缺血后功能障碍,可能是通过避免心脏缺血期间产生的细胞内钙超载。

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