Uematsu M, Okada M
Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, Massaachusetts, USA.
Jpn J Thorac Cardiovasc Surg. 1998 Sep;46(9):860-7. doi: 10.1007/BF03217834.
We hypothesized that the adenosine administration during the early reperfusion period might affect ischemic preconditioning (IPC) and might reduce infarct size and enhance post-ischemic functional recovery. Twenty-four anesthetized rabbits underwent 30 min. normothermic global ischemia with 120 min. reperfusion in a buffer-perfused isolated, paced heart model and divided into four groups. Global ischemic hearts (GI, n = 6) were subjected to 30 min. global ischemia without intervention. Control hearts (n = 6) were subjected to perfusion without ischemia. Ischemic preconditioned hearts (IPC, n = 6) were subjected to one cycle of 5 min. global ischemia and 5 min. reperfusion prior to global ischemia. IPC + Ado hearts (n = 6) received IPC and adenosine administration (100 m mol/L) during 3 min. early reperfusion period. Post-ischemic functional recovery was better in IPC + Ado hearts as compared to GI and IPC hearts, but the effect of post-ischemic functional recovery in IPC + Ado hearts became weaker during 120 min. reperfusion after prolong ischemic insult. Infarct size were 1.0 +/- 0.3% in Control hearts, 32.9 +/- 5.1% in GI hearts, 13.8 +/- 1.3% in IPC hearts and 8.1 +/- 0.9% in IPC + Ado hearts Infarct size in IPC hearts was significantly decreased (p < 0.01) as compared to GI hearts. The reduction rate against myocardial necrosis in IPC + Ado hearts versus GI hearts was higher as compared to IPC hearts versus GI hearts (p < 0.001, IPC + Ado hearts vs GI hearts; p < 0.01, IPC hearts vs GI hearts; p = ns, IPC + Ado hearts vs Control hearts). These data suggest that adenosine administration during the early reperfusion period reinforce IPC effect and reduce myocardial reperfusion injury. Cardiomyoprotective effects of IPC and exogenous adenosine are exerted during early reperfusion after coronary occlusion in the isolated perfused rabbit hearts.
我们推测，在早期再灌注期间给予腺苷可能会影响缺血预处理（IPC），并可能减小梗死面积，增强缺血后功能恢复。24只麻醉的兔子在缓冲液灌注的离体起搏心脏模型中经历30分钟的常温全心缺血和120分钟的再灌注，并分为四组。全心缺血心脏（GI，n = 6）接受30分钟的全心缺血，不进行干预。对照心脏（n = 6）接受无缺血的灌注。缺血预处理心脏（IPC，n = 6）在全心缺血之前接受一个周期的5分钟全心缺血和5分钟再灌注。IPC + Ado心脏（n = 6）在3分钟的早期再灌注期接受IPC和腺苷给药（100 mmol/L）。与GI和IPC心脏相比，IPC + Ado心脏的缺血后功能恢复更好，但在延长缺血损伤后的120分钟再灌注期间，IPC + Ado心脏的缺血后功能恢复效果变弱。对照心脏的梗死面积为1.0±0.3%，GI心脏为32.9±5.1%，IPC心脏为13.8±1.3%，IPC + Ado心脏为8.1±0.9%。与GI心脏相比，IPC心脏的梗死面积显著减小（p < 0.01）。与GI心脏相比，IPC + Ado心脏相对于GI心脏的心肌坏死减少率高于IPC心脏相对于GI心脏的减少率（p < 0.001，IPC + Ado心脏与GI心脏相比；p < 0.01，IPC心脏与GI心脏相比；p =无显著性差异，IPC + Ado心脏与对照心脏相比）。这些数据表明，在早期再灌注期间给予腺苷可增强IPC效应并减少心肌再灌注损伤。IPC和外源性腺苷的心肌保护作用在离体灌注兔心脏冠状动脉闭塞后的早期再灌注期间发挥作用。
