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拉扎罗类药物(U74500A)可预防心脏保存24小时后的血管和心肌功能障碍。一项基于交叉循环血液灌注兔心脏的研究。

Lazaroid (U74500A) prevents vascular and myocardial dysfunction after 24-hour heart preservation. A study based on cross-circulated blood-perfused rabbit hearts.

作者信息

Nishida T, Morita S, Miyamoto K, Masuda M, Tominaga R, Kawachi Y, Yasui H

机构信息

Department of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Circulation. 1996 Nov 1;94(9 Suppl):II326-31.

PMID:8901769
Abstract

BACKGROUND

The prevention of ventricular and vascular dysfunction has been recognized as an important factor in heart preservation. Because lipid peroxidation may cause cell membrane injury after ischemia and reperfusion, we hypothesized that the administration of a lipid peroxidation inhibitor lazaroid (U74500A) would result in an improvement of functional recovery after the 24-hour preservation period.

METHODS AND RESULTS

An isolated rabbit heart preparation perfused with support rabbit blood was used. Before preservation, 4 mg/kg of either lazaroid or solvent was given to donor rabbits. The hearts were preserved with University of Wisconsin solution for 24 hours at 0 degree C. The working model preparation (n = 7 in each group) showed a better cardiac output (74.6 +/- 25.7 versus 192.7 +/- 19.6 mL/min, P < .0001) and a lower lipid peroxide level (2.1 +/- 1.3 versus 0.6 +/- 0.3 nmol/mL. P < .05) of the coronary effluent in the heart treated with lazaroid. With a Langendorff preparation (n = 7 in each group), we evaluated the vascular dilatory function. The endothelial function assessed by the percentage increase of coronary flow in response to acetylcholine in the solvent group was significantly lower than that of the lazaroid group (69 +/- 24% versus 140 +/- 67%, P < .05), whereas no significant difference was observed between the groups regarding endothelium-independent vasodilatation as assessed by the responses to nitroglycerin and nitroprusside.

CONCLUSIONS

These results demonstrated an improved ventricular and endothelial function in the rabbit pretreated with lazaroid before preservation accompanied by a reduction of lipid peroxidation, indicating the potential benefits for long-term heart preservation.

摘要

背景

预防心室和血管功能障碍已被视为心脏保存中的一个重要因素。由于脂质过氧化可能在缺血再灌注后导致细胞膜损伤,我们推测给予脂质过氧化抑制剂拉扎罗肽(U74500A)会使保存24小时后的功能恢复得到改善。

方法与结果

采用灌注兔血的离体兔心制备模型。在保存前,给供体兔注射4mg/kg的拉扎罗肽或溶剂。心脏在0℃用威斯康星大学溶液保存24小时。工作模型制备(每组n = 7)显示,用拉扎罗肽处理的心脏心输出量更高(74.6±25.7对192.7±19.6mL/min,P <.0001),冠状流出液中的脂质过氧化物水平更低(2.1±1.3对0.6±0.3nmol/mL,P <.05)。在Langendorff制备模型(每组n = 7)中,我们评估了血管舒张功能。溶剂组中乙酰胆碱刺激后冠状动脉血流增加百分比所评估的内皮功能显著低于拉扎罗肽组(69±24%对140±67%,P <.05),而在硝酸甘油和硝普钠刺激所评估的非内皮依赖性血管舒张方面,两组之间未观察到显著差异。

结论

这些结果表明,在保存前用拉扎罗肽预处理的兔心室和内皮功能得到改善,同时脂质过氧化减少,这表明对长期心脏保存具有潜在益处。

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