Felix S B, Stangl V, Frank T M, Harms C, Berndt T, Kästner R, Baumann G
Medizinische Klinik und Poliklinik I, Charité, Humboldt-Universität zu Berlin, Germany.
Cardiovasc Res. 1997 Jul;35(1):68-79. doi: 10.1016/s0008-6363(97)00105-3.
The aim of this study was to investigate whether cardiodepressant mediators are released after myocardial ischaemia during reperfusion.
Using a double heart model, the effect of the reoxygenated coronary effluent of an isolated guinea pig heart on a sequentially perfused second heart was studied under control conditions and after 10 min ischaemia of the first heart. Investigation of the modulating role of known autacoids took place by using free radical scavengers, an NO synthase inhibitor and adenosine receptor antagonists. In order to identify the chemical nature of cardiac metabolites, the coronary effluent was also subjected to different chemical treatment modes.
No haemodynamic changes were observed during sequential perfusion under control conditions. After 10 min of global ischaemia in heart I, a marked decrease in LVP (-22%), LVdP/dtmax (-43%), LVdP/dtmin (-41%) and coronary perfusion pressure (-25%) was measured in heart II during sequential perfusion. The negative inotropic effect was rapid in onset and reversible within 5 min; free radicals, nitric oxide and adenosine were not involved. Storage of the coronary effluent of the first heart up to 24 h, heating, or protease treatment did not modify its cardiodepressant effects on the second sequentially perfused heart.
These results suggest the release--from an isolated heart after ischaemia during reperfusion--of a cardiodepressant mediator which induces a potent reversible negative inotropic effect on a sequentially perfused heart. The mediator is stable and in all probability not a protein.
本研究旨在调查心肌缺血再灌注后是否会释放心脏抑制介质。
使用双心脏模型,在对照条件下以及第一颗心脏缺血10分钟后,研究分离的豚鼠心脏复氧后的冠状动脉流出液对依次灌注的第二颗心脏的影响。通过使用自由基清除剂、一氧化氮合酶抑制剂和腺苷受体拮抗剂来研究已知自分泌物质的调节作用。为了确定心脏代谢产物的化学性质,冠状动脉流出液也接受了不同的化学处理方式。
在对照条件下依次灌注期间未观察到血流动力学变化。在心脏I全局缺血10分钟后,在依次灌注期间测量到心脏II的左心室压(LVP)显著下降(-22%)、左心室压最大变化速率(LVdP/dtmax)显著下降(-43%)、左心室压最小变化速率(LVdP/dtmin)显著下降(-41%)以及冠状动脉灌注压显著下降(-25%)。负性肌力作用起效迅速且在5分钟内可逆;自由基、一氧化氮和腺苷未参与其中。将第一颗心脏的冠状动脉流出液储存长达24小时、加热或进行蛋白酶处理均未改变其对依次灌注的第二颗心脏的心脏抑制作用。
这些结果表明,在再灌注期间缺血后的离体心脏会释放一种心脏抑制介质,该介质对依次灌注的心脏会诱导出一种强效的可逆性负性肌力作用。该介质稳定,很可能不是蛋白质。