ADENOSINE CARDIOPLEGIA - REDUCING REPERFUSION INJURY OF THE ISCHEMIC MYOCARDIUM

被引：10

作者：

BOEHM, DH

HUMAN, PA

VONOPPELL, U

OWEN, P

REICHENSPURNER, H

OPIE, LH

ROSE, AG

REICHART, B

机构：

[1] Department of Pathology, University of Cape Town Medical School, Cape Town

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 10期

关键词：

CARDIOPLEGIA; ADENOSINE; BABOON; REPERFUSION INJURY; ISCHEMIA;

D O I：

10.1016/1010-7940(91)90108-V

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Hyperkalaemia-induced hypopolarization of the sarcolemnal membrane during standard crystalloid cardioplegic arrest potentiates calcium influx during reperfusion and is associated with depletion of high-energy phosphate reserves. Adenosine has been shown to induce fast cardiac arrest whilst preserving membrane hyperpolarization in an isolated rat heart model [14]. In this study we compared the efficacy of adenosine, both as an arresting agent and as an ultrastructural, haemodynamic and high-energy phosphate preserving agent, in an in situ global ischemia model in the baboon with St. Thomas' Hospital solution No. 2 (ST2; n = 8) and with Krebs-Henseleit buffer (KHB; n = 7). The addition of 10 mM adenosine to the non-cardioplegic KHB (ADO; n = 8) improved haemodynamic recovery significantly in terms of cardiac index (91.6% +/- 7.2 vs 59.9% +/- 9.9) and stroke volume index (101.6% +/- 8.9 vs 55.6% +/- 10.0) and was not statistically distinguishable from the ST2 with regard to cardiac index (91.6% +/- 7.2 vs 94.8% +/- 5.8), stroke volume index (101.6% +/- 8.9 vs 114.0% +/- 8.3) or left ventricular dP/dt (73.1% +/- 9.9 vs 87.0% +/- 12.4). Adenosine triphosphate was best preserved with ADO (103.5% +/- 21.1 vs 67.9% +/- 9.3 and 48.5% +/- 8.7) although this was not statistically significant. This suggests therefore that the mechanism of cardioprotection by adenosine occurs by means other than its role as high-energy phosphate precursor.

引用

页码：542 / 545

页数：4

共 15 条

[11]

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[12]

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[13]

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[14]

Schubert T., Vetter H., Owen P., Reichart B., Opie L.H., Adenosine cardioplegia. Adenosine versus potassium cardioplegia: Effects on cardiac arrest and post-ischemic recovery in the isolated rat heart, J Thorac Cardiovasc Surg, 98, pp. 1057-1065, (1989)

[15]

Wyatt D.A., Ely S.W., Lasley R.D., Walsh R., Mainwaring R., Berne M., Mentzer R.M., Purine-enriched asanguineous cardioplegia retards adenosine triphosphate degradation during ischemia and improves post-ischemic ventricular function, J Thorac Cardiovasc Surg, 97, pp. 771-778, (1989)

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