间歇性顺行温血心脏停搏法介导的内皮依赖性血管舒张的时间依赖性

Curro D, Bombardieri G, Barilaro C, Di Francesco P, Varano C, Possati G, Pragliola C

Department of Cardiology, Catholic University, Rome, Italy.

Ann Thorac Surg. 1997 Nov;64(5):1354-9. doi: 10.1016/S0003-4975(97)00841-2.

BACKGROUND

The technique of intermittent antegrade warm blood cardioplegia (IAWBC) exposes the heart to brief periods of normothermic ischemia. This may impair endothelial function in coronary arteries.

METHODS

Three cardioplegic technique were tested in porcine hearts arrested for 32 to 36 minutes and reperfused for 30 minutes: IAWBC, antegrade cold blood cardioplegia (ACBC), and antegrade cold crystalloid cardioplegia (ACCC). In the hearts arrested with IAWBC, three different intervals of ischemia were used: three 10-minute intervals (IAWBC1), two 15-minute intervals (IAWBC2), and one 30-minute interval (IAWBC3). Rings from the coronary arteries were used to evaluate in vitro the contractile responses to U46619 and the relaxant responses to bradykinin, A23187, and sodium nitroprusside.

RESULTS

All six groups (treatment groups and control group) displayed similar responses to U46619 (30 nmol/L) and nitroprusside. In the IAWBC1, IAWBC2, AND ACBC groups, endothelium-dependent relaxations to bradykinin and A23187 were preserved compared with controls, whereas those of the ACCC and IAWBC3 groups were significantly impaired (bradykinin: control, 8.72 +/- 0.07; IAWBC1, 8.73 +/- 0.03; IAWBC2, 8.65 +/- 0.05; IAWBC3, 8.30 +/- 0.07 [p < 0.05]; ACBC, 8.50 +/- 0.03; ACCC, 8.25 +/- 0.09 [p < 0.05]; A23187: control, 7.07 +/- 0.08; IAWBC1, 7.07 +/- 0.06; IAWBC2, 7.04 +/- 0.03; IAWBC3, 6.64 +/- 0.01 [p < 0.05]; ACBC, 6.80 +/- 0.05; ACCC, 6.60 +/- 0.08 [p < 0.05]; nitroprusside: control, 6.19 +/- 0.1; IAWBC1, 6.19 +/- 0.07; IAWBC2, 6.03 +/- 0.03; IAWBC3, 6.08 +/- 0.05; ACBC, 6.04 +/- 0.2; ACCC, 6.05 +/- 0.03; all values are expressed as the negative logarithm of the concentration producing 50% of the maximal response).

CONCLUSIONS

Myocardial preservation with IAWBC with ischemic intervals of 15 minutes or shorter does not alter the endothelium-dependent relaxation to bradykinin or A23187 in porcine coronary arteries, but these responses are significantly impaired by ACCC and IAWBC with an ischemic interval of 30 minutes.

背景

间歇性顺行温血心脏停搏（IAWBC）技术使心脏暴露于短时间的常温缺血状态。这可能会损害冠状动脉的内皮功能。

方法

在猪心脏停搏32至36分钟并再灌注30分钟的情况下，测试了三种心脏停搏技术：IAWBC、顺行冷血心脏停搏（ACBC）和顺行冷晶体心脏停搏（ACCC）。在用IAWBC使心脏停搏的过程中，使用了三种不同的缺血间隔：三个10分钟间隔（IAWBC1）、两个15分钟间隔（IAWBC2）和一个30分钟间隔（IAWBC3）。取自冠状动脉的血管环用于体外评估对U46619的收缩反应以及对缓激肽、A23187和硝普钠的舒张反应。

结果

所有六组（治疗组和对照组）对U46619（30 nmol/L）和硝普钠的反应相似。在IAWBC1、IAWBC2和ACBC组中，与对照组相比，对缓激肽和A23187的内皮依赖性舒张得以保留，而ACCC组和IAWBC3组的内皮依赖性舒张则明显受损（缓激肽：对照组，8.72±0.07；IAWBC1组，8.73±0.03；IAWBC2组，8.65±0.05；IAWBC3组，8.30±0.07 [p<0.05]；ACBC组，8.50±0.03；ACCC组，8.25±0.09 [p<0.05]；A23187：对照组，7.07±0.08；IAWBC1组，7.07±0.06；IAWBC2组，7.04±0.03；IAWBC3组，6.64±0.01 [p<0.05]；ACBC组，6.80±0.05；ACCC组，6.60±0.08 [p<0.05]；硝普钠：对照组，6.19±0.1；IAWBC1组，6.19±0.07；IAWBC2组，6.03±0.03；IAWBC3组，6.08±0.05；ACBC组，6.04±0.2；ACCC组，6.05±0.03；所有数值均表示为产生最大反应50%的浓度的负对数）。