McDonough K H
Department of Physiology, Louisiana State University Medical Center, New Orleans 70112, USA.
Alcohol Clin Exp Res. 1997 Aug;21(5):869-73.
We have previously demonstrated that chronic alcohol consumption (8 to 10 weeks with ethanol as 36% of the caloric intake) does not exacerbate the effects of ischemia reperfusion injury on the heart. In those same studies, however, Gram-negative sepsis caused myocardial depression in both control and alcoholic rats, but also protected hearts from further damage due to ischemia-reperfusion. In the present study, we determined if preconditioning, a very short ischemia-reperfusion episode that protects the heart from more prolonged ischemia, would have similar effects on hearts from alcoholic and control rats with or without sepsis. Thus, rats were fed a liquid diet supplemented with ethanol or dextrin for 8 to 10 weeks. Some alcoholic and control rats were made septic with Escherichia coli injected into the subcutaneous space, whereas others received an injection of sterile saline. Isolated, isovolumically beating hearts were studied the following day. Hearts were made ischemic for 5 min, reperfused for 5 min, and then made ischemic for 35 min and reperfused for 25 min. Data from similar groups of hearts receiving only 35 min ischemia, and studied at the same time as the present groups, have been previously reported. The 5-min preconditioning episode was more effective in protecting hearts in the alcohol group than in the control group. Postischemic left ventricular developed pressure and +dP/dtmax were not significantly decreased from the preischemic values in the alcohol group, but were significantly decreased in the control group. The time to recovery of spontaneous contractions was decreased by preconditioning in the alcohol group but not in the control group, and the recovery of coronary flow was enhanced in the alcohol group, but not in the control group by pre-conditioning. Thus a single 5-min ischemic procedure was effective in protecting the heart from prolonged ischemia in the alcohol group, whereas it was not sufficient to elicit protection in the control group. Sepsis depressed preischemic function in both groups, but recovery from ischemia was complete.
我们之前已经证明,长期饮酒(以乙醇作为热量摄入的36%,持续8至10周)并不会加剧缺血再灌注损伤对心脏的影响。然而,在那些相同的研究中,革兰氏阴性菌败血症在对照组和酒精喂养的大鼠中均导致心肌抑制,但同时也保护心脏免受缺血再灌注的进一步损伤。在本研究中,我们确定预处理(一种非常短暂的缺血再灌注过程,可保护心脏免受更长时间的缺血损伤)对有或无败血症的酒精喂养大鼠和对照大鼠的心脏是否有类似影响。因此,大鼠被给予补充了乙醇或糊精的液体饮食8至10周。一些酒精喂养和对照大鼠通过皮下注射大肠杆菌而发生败血症,而其他大鼠则接受无菌盐水注射。次日对分离出的等容跳动心脏进行研究。使心脏缺血5分钟,再灌注5分钟,然后再缺血35分钟并再灌注25分钟。之前已经报道过来自仅接受35分钟缺血且与当前组同时进行研究的类似心脏组的数据。在酒精组中,5分钟的预处理过程在保护心脏方面比对照组更有效。缺血后酒精组的左心室舒张末压和 +dP/dtmax与缺血前值相比没有显著降低,但对照组则显著降低。酒精组中预处理缩短了自发收缩恢复的时间,而对照组则没有,并且酒精组中预处理增强了冠脉血流的恢复,而对照组则没有。因此,单次5分钟的缺血过程在酒精组中可有效保护心脏免受长时间缺血损伤,而在对照组中则不足以引发保护作用。败血症在两组中均降低了缺血前的心脏功能,但缺血后的恢复是完全的。