长链甘油三酯可改善清醒犬心肌顿抑后的恢复。

Long-chain triglycerides improve recovery from myocardial stunning in conscious dogs.

作者信息

Van de Velde M, Wouters P F, Rolf N, Van Aken H, Flameng W, Vandermeersch E

机构信息

Department of Anaesthesiology, Katholieke Universiteit, Leuven, Belgium.

出版信息

Cardiovasc Res. 1996 Dec;32(6):1008-15. doi: 10.1016/s0008-6363(96)00165-4.

DOI:10.1016/s0008-6363(96)00165-4

PMID:9015403

Abstract

OBJECTIVES

Free fatty acid (FFA) oxidation is depressed in the postischaemic stunned myocardium and recovers in parallel with the normalization of contractile performance. Assuming a causal role for this metabolic disturbance in the pathogenesis of stunning, we questioned whether exogenous administration of high dose triglycerides during reperfusion of postischaemic myocardium, could improve its functional recovery.

METHODS

Thirteen dogs were chronically instrumented to measure global and regional haemodynamics and to produce a 10 min episode of regional myocardial ischaemia. In 7 dogs, Intralipid 20% was administered i.v. during the reperfusion phase. Contractile recovery of stunned myocardium was compared with control saline treatments. The series were repeated in another 6 animals, but oxfenicine (CPT I inhibitor) preceeded Intralipid during reperfusion.

RESULTS

Contractile recovery of stunned myocardium was faster and more extensive when Intralipid was administered during reperfusion than with saline treatment (wall thickening fraction 86 +/- 6% of preischaemic controls versus 52 +/- 11% at 90 min post-reperfusion; P < 0.05). Oxfenicine pretreatment completely abolished this beneficial effect.

CONCLUSIONS

Exogenous administration of triglycerides during reperfusion of postischaemic myocardium improves functional recovery from stunning. This beneficial effect most likely operates through enhanced FFA availability and/or oxidation since it could be abolished by selective inhibition of the carnitine palmitoyl I enzyme.

摘要

目的

缺血后心肌顿抑时游离脂肪酸（FFA）氧化受到抑制，并随着收缩功能的恢复而恢复正常。假设这种代谢紊乱在心肌顿抑的发病机制中起因果作用，我们探讨了在缺血后心肌再灌注期间外源性给予高剂量甘油三酯是否能改善其功能恢复。

方法

对13只犬进行长期仪器植入，以测量整体和局部血流动力学，并造成10分钟的局部心肌缺血。在7只犬中，在再灌注阶段静脉注射20%的英脱利匹特。将顿抑心肌的收缩恢复情况与生理盐水对照处理进行比较。该系列实验在另外6只动物中重复进行，但在再灌注期间先给予奥芬尼辛（肉碱棕榈酰转移酶I抑制剂），然后给予英脱利匹特。