Lucchesi B R, Burmeister W E, Lomas T E, Abrams G D
J Pharmacol Exp Ther. 1976 Nov;199(2):310-28.
The effects of the dimethyl quarternary analog of propranolol, UM-272, on myocardial infarct volume were studied in the canine heart. Myocardial infarction was produced by occlusion of the left circumflex coronary artery for 60 minutes followed by reperfusion and quantitation of infarct volume 24 hours later. Groups of dogs were either untreated or pretreated with UM-272 with an initial loading dose of 5.0 mg/kg (group A) or 2.5 mg/kg (group B) 30 minutes before occlusion of the left circumflex coronary artery. Both group A and group B animals received additional doses of 2.5 mg/kg of UM-272 every 90 minutes for a period of 6 hours so that the total respective doses were 15 and 12.5 mg/kg. Control animals received comparable volumes of 0.9% sodium chloride solution. All animals were followed throughout the 6-hour procedure with continuous electrocardiographic recordings which were used to assess the effects of acute myocardial ischemia upon disturbances in cardiac rhythm and the effects of drug treatment. Dogs which survived the procedure were given tetracycline i.v. the next day and sacrificed 1 hour later by an overdose of pentobarbital sodium. The hearts were removed and the left ventricle was sliced and examined first under ultraviolet light to localize the ischemic zone by noting the tetracycline fluorescence. The ventricular slices were next incubated in nitro blue tetrazolium which stains normal myocardial tissue, thus allowing one to quantitate the volume of infarcted myocardium by excising and weighing the nonstained and stained muscle separately. The untreated control group had an infarct volume of 23.8 +/- 3.2 g/100 g of left ventricle. The treated animals in groups A and B had respective infarct volumes of 2.3 +/- 0.8 g/100 g (P less than .001) and 7.0 +/- 3.3 g/100 g (P less than .025) of left ventricle. During the acute phase of ischemia and reperfusion, arrhythmias and alterations in the ST-segment, R-wave amplituted and development of pathologic Q-waves were more prominent in the untreated animals and almost totally absent in the treated animals. UM-272 produced a dose-dependent decrease in heart rate as well as a decrease in developed isometric tension. Pretreatment with UM-272 did not prevent the derangement of function in the ischemic zone nor did it permit a return of function upon reperfusion, even though it reduced the degree of cellular damage resulting from 60 minutes of regional ischemia. A possible mechanism for the protective effect of UM-272 may be through its ability to reduce myocardial contractility and heart rate, both of which would reduce myocardial oxygen consumption and thus produce a more favorable balance between myocardial oxygen supply and myocardial oxygen demand.
在犬心脏中研究了普萘洛尔的二甲基季铵类似物UM - 272对心肌梗死体积的影响。通过闭塞左旋冠状动脉60分钟,随后再灌注,并在24小时后对梗死体积进行定量来制造心肌梗死。在左旋冠状动脉闭塞前30分钟,将犬分组,一组不进行治疗,另一组用UM - 272预处理,初始负荷剂量为5.0mg/kg(A组)或2.5mg/kg(B组)。A组和B组动物每90分钟额外接受2.5mg/kg的UM - 272,持续6小时,以使各自的总剂量分别为15mg/kg和12.5mg/kg。对照动物接受等量的0.9%氯化钠溶液。在整个6小时的过程中,对所有动物进行连续心电图记录,以评估急性心肌缺血对心律失常的影响以及药物治疗的效果。在手术中存活的犬在第二天静脉注射四环素,并在1小时后用过量的戊巴比妥钠处死。取出心脏,将左心室切片,首先在紫外线下检查,通过观察四环素荧光来定位缺血区域。然后将心室切片在硝基蓝四氮唑中孵育,该试剂可使正常心肌组织染色,从而通过分别切除和称量未染色和染色的肌肉来定量梗死心肌的体积。未治疗的对照组梗死体积为23.8±3.2g/100g左心室。A组和B组的治疗动物左心室梗死体积分别为2.3±0.8g/100g(P<0.001)和7.0±3.3g/100g(P<0.025)。在缺血和再灌注的急性期,未治疗的动物心律失常以及ST段、R波振幅的改变和病理性Q波的出现更为明显,而治疗动物几乎完全没有这些情况。UM - 272使心率呈剂量依赖性降低,同时等长收缩张力也降低。尽管UM - 272预处理可减少60分钟局部缺血导致的细胞损伤程度,但它并不能防止缺血区域功能紊乱,也不能使再灌注后功能恢复。UM - 272发挥保护作用的一种可能机制可能是通过其降低心肌收缩力和心率的能力,这两者都将减少心肌耗氧量,从而在心肌氧供应和心肌氧需求之间产生更有利的平衡。