Minatoguchi S, Kariya T, Uno Y, Arai M, Ohno M, Hashimoto K, Nishida Y, Wo D J, Fujiwara H
Second Department of Internal Medicine, Gifu University School of Medicine, Japan.
Heart Vessels. 1997;12(6):294-9. doi: 10.1007/BF02766806.
In rabbits, both the stimulation of alpha1-adrenoceptors and ischemic preconditioning (PC) reduce infarct size. One candidate for the mechanism of PC is noradrenaline (NA), which stimulates alpha1-adrenoceptors in the myocardium during PC. Opening of the K(ATP) channel is considered to be another candidate for PC, since a K(ATP) channel blocker, glibenclamide, blocks the infarct size-reducing effect of the PC of 5-min ischemia and 5-min reperfusion in rabbits anesthetized with ketamine + xylazine. However, in rabbits anesthetized with pentobarbital, the infarct size-reducing effect of PC was not blocked by glibenclamide. The effect of glibenclamide on the PC effect thus differs depending on the anesthesia used. Therefore, we speculated that the increase in cardiac interstitial NA levels induced by PC may be modified by the anesthesia used, thus regulating the effect of glibenclamide on the PC effect. In open-chest Japanese white male rabbits anesthetized with pentobarbital or ketamine + xylazine, myocardial interstitial NA levels were measured before and during the PC of 5-min ischemia and 5-min reperfusion in the presence or absence of the K(ATP) channel blocker, glibenclamide (0.3 mg/kg, i.v.), using a microdialysis technique. The NA levels were measured using high-performance liquid chromatography coupled with electrochemical detection. The PC of 5-min ischemia and 5-min reperfusion significantly elevated the interstitial NA level. This increase in the NA level was not blocked by glibenclamide under anesthesia with pentobarbital. Under anesthesia with ketamine + xylazine, the PC did not cause an increase in the myocardial interstitial NA level in either the absence or the presence of glibenclamide. In conclusion, PC elevates the myocardial interstitial NA level, and this elevation is not mediated through the opening of the K(ATP) channel under anesthesia with pentobarbital. Under anesthesia with ketamine + xylazine, PC does not cause an increase in the myocardial interstitial NA level. This may explain the discrepancy in the blocking effect of glibenclamide on the infarct size-reducing effect of PC between anesthesia with pentobarbital and ketamine + xylazine.
在兔中,刺激α1 - 肾上腺素能受体和缺血预处理(PC)均可减小梗死面积。PC机制的一个候选因素是去甲肾上腺素(NA),其在PC期间刺激心肌中的α1 - 肾上腺素能受体。K(ATP)通道开放被认为是PC的另一个候选因素,因为K(ATP)通道阻滞剂格列本脲可阻断氯胺酮+赛拉嗪麻醉的兔5分钟缺血和5分钟再灌注的PC的梗死面积减小效应。然而,在戊巴比妥麻醉的兔中,PC的梗死面积减小效应未被格列本脲阻断。因此,格列本脲对PC效应的影响因所用麻醉而异。所以,我们推测PC诱导的心脏间质NA水平升高可能会因所用麻醉而改变,从而调节格列本脲对PC效应的影响。在戊巴比妥或氯胺酮+赛拉嗪麻醉的开胸日本雄性白兔中,在有或无K(ATP)通道阻滞剂格列本脲(0.3mg/kg,静脉注射)的情况下,采用微透析技术在5分钟缺血和5分钟再灌注的PC前后测量心肌间质NA水平。使用高效液相色谱结合电化学检测测量NA水平。5分钟缺血和5分钟再灌注的PC显著提高了间质NA水平。在戊巴比妥麻醉下,NA水平的这种升高未被格列本脲阻断。在氯胺酮+赛拉嗪麻醉下,无论有无格列本脲,PC均未引起心肌间质NA水平升高。总之,PC可提高心肌间质NA水平,且在戊巴比妥麻醉下这种升高并非通过K(ATP)通道开放介导。在氯胺酮+赛拉嗪麻醉下,PC不会引起心肌间质NA水平升高。这可能解释了戊巴比妥麻醉和氯胺酮+赛拉嗪麻醉之间格列本脲对PC梗死面积减小效应的阻断作用存在差异的原因。