右美托嘧啶预处理对离体大鼠心脏再灌注心律失常的影响

目的观察右美托嘧啶预处理对缺血再灌注损伤心脏后心功能及再灌注心律失常的影响。方法取离体大鼠心脏建立Langendorff灌注模型,随机分人以下三组(每组10例):对照组,平衡后继续灌注120分钟;缺血再灌注组:平衡后灌注30分钟,随后停灌30分钟,复灌60分钟;右美托嘧啶预处理组,平衡后先以右美托嘧啶(10nmol/L)预处理,随后停灌30分钟,复灌60分钟。监测血流动力学及心电图参数,测定冠脉流出液肌钙蛋白Ⅰ水平及细胞内活性氧水平。结果与缺血再灌注组相比,右美托嘧啶预处理组心脏的左室发展压、左室内压上升/下降速率、心率增加,左室舒张末压力降低(P均0.05);冠脉流出液肌钙蛋白Ⅰ水平和细胞内活性氧水平降低(P均0.05);室性早搏个数、室速发作时间、室颤发作时间、再灌注心律失常评分降低(P均0.05)。结论右美托嘧啶预处理能改善缺血再灌注损伤后离体大鼠心脏的功能及再灌注心律失常的严重程度。     

伊贝沙坦对缺血再灌注心律失常的作用实验研究

目的:探讨血管紧张素Ⅱ受体拮抗剂伊贝沙坦对缺血再灌注心律失常的作用及其机制。方法:32只Sprague-Dawley雄性大鼠分为缺血/复灌对照组,缺血/复灌+伊贝沙坦(100umol/L)组,缺血/复灌+伊贝沙坦(50umol/L)组,缺血/复灌+伊贝沙坦(100umol/L)+CsA(1umol/L)组,每组8只。观察各组心脏离体灌注下左室发展压(LVDP)、左室舒张末压(LVEDP)、心率(HR)、最大收缩/舒张速率(±dP/dtmax)、冠脉流量(CF)、灌流液乳酸脱氢酶(LDH)及心律失常评分。结果:单用伊贝沙坦组LVDP、LVEDP、LDH及心律失常评分显著低于缺血/复灌对照组(P<0.01);±dP/dtmax、CF显著高于缺血/复灌对照组(P<0.05),合灌环胞菌素A可以部分甚至全部逆转伊贝沙坦的作用。结论:伊贝沙坦对离体大鼠缺血/再灌注心肌有保护作用,减少再灌注心律失常发生,部分可能是通过激活钙调神经磷酸酶起作用。     

下肢缺血预处理调控未成熟心肌细胞凋亡的研究

目的探讨下肢缺血预处理调控未成熟心肌细胞凋亡和对bcl-2、bax、fas表达的影响。方法采用兔离体心脏Langendorff灌注模型,24只幼兔随机分为三组：对照组（c组,n=8）：仅灌注KH液180rain;缺血／再灌组（I／R组,n=8）：心脏灌注20min后,停灌60min,复灌100min;下肢缺血预处理组（LIP组,n=8）,反复3次阻断双下肢血流5min／放开5min,建立Langendorff模型,然后重复I／R组缺血,再灌方法。细胞原位标记与半定量分析细胞凋亡和bcl-2、bax、fas蛋白表达。结果凋亡细胞原位标记与半定量分析：LIP组与I／R组比较,心肌细胞凋亡率明显减少,bcl-2表达明显增多,bax、fas表达明显减少。结论下肢缺血预处理可减少心肌细胞凋亡和调控心肌bcl-2、bax、fas表达。     

辛伐他汀缺血后处理对大鼠心肌缺血再灌注损伤的保护作用

目的探讨辛伐他汀缺血后处理对大鼠心肌缺血再灌注（I/R）损伤的保护作用及机制。方法采用Langendorff离体心脏灌流模型,将32只大鼠随机分为四组各8只。对照组用改良K-H缓冲液持续灌流;I/R组用改良K-H缓冲液稳定灌注、停灌、再灌;治疗组用改良K-H缓冲液稳定灌注、停灌后,在K-H缓冲液中加入辛伐他汀20μmol/L再灌;K-H缓冲液再灌;N-硝基-L-精氨酸甲酯（L-NAME）组用改良K-H缓冲液稳定灌注、停灌后,在K-H缓冲液中加入辛伐他汀20μmol/L、L-NAME 100μmol/L再灌,K-H缓冲液再灌。观察各组再灌注心律失常发生情况,检测其冠脉流出液中的肌酸激酶（CK）、乳酸脱氢酶（LDH）、NO,心肌组织总超氧化物歧化酶（T-SOD）活性、丙二醛（MDA）及细胞凋亡指数（AI）。结果与I/R组比较,治疗组心律失常发生率下降,CK、LDH、MDA及细胞AI降低,T-SOD活性、NO升高（P均〈0.01）;与治疗组比较,L-NAME组心律失常发生率升高,CK、LDH、MDA及细胞AI升高,T-SOD活性、NO降低（P均〈0.01）。结论辛伐他汀缺血后处理能减轻大鼠心肌I/R损伤,其作用机制与清除氧自由基、增加NO含量、减少心肌细胞凋亡有关。     

粒细胞集落刺激因子通过PI3K-Akt通路抑制缺血再灌注损伤

目的:研究经冠状动脉(冠脉)内注入粒细胞集落刺激因子(G-CSF)对大鼠心肌缺血再灌注损伤的预防作用,及其与PI3K-Akt信号转导途径的关系。方法:制备大鼠心肌缺血再灌注模型。再灌注同时经冠脉内给予G-CSF或G-CSF+PI3K激酶抑制剂(LY294002),灌注120min后应用TUNEL法检测细胞凋亡,免疫组织化学法观察凋亡相关蛋白Bax及Bcl-2及caspase-3表达情况,免疫印迹检测总-Akt(t-Akt)及磷酸化Akt(p-Akt)表达。结果:缺血再灌注同时给予冠脉内G-CSF治疗能够显著减轻缺血区心肌细胞凋亡,降低Bax、caspase-3的表达,增高心肌细胞内Bcl-2表达,同时p-Akt的蛋白水平显著增高(P<0.01)。LY294002阻断Akt活化后,抑制了G-CSF诱导的抗心肌细胞凋亡作用。结论:缺血再灌注同时冠脉内给予G-CSF可保护梗死区残存的心肌细胞,减少缺血再灌注所诱导的心肌细胞凋亡,其保护机制与PI3K-Akt信号通路有关。     

硝酸甘油对心肌细胞凋亡和Fas基因蛋白及mRNA表达的影响

目的　探讨硝酸甘油对持续缺血和缺血再灌注损伤时心肌细胞凋亡和 Fas基因蛋白及 m RNA表达的影响。方法　将大白鼠随机分为 5组 ,以活结结扎左冠状动脉的前降支 ,分别造成阻断冠脉血流和再灌注。以缺口末端标记法 (TUNEL)标记凋亡细胞 ;以 S- P免疫组化及逆转录聚合酶链反应 (RT- PCR)法分别检测 Fas基因蛋白与 m RNA的表达变化。结果　凋亡细胞原位标记与半定量分析表明 :硝酸甘油处理组与持续缺血组、缺血再灌注组比较心肌细胞凋亡程度明显降低 ,Fas基因蛋白及 m RNA表达明显减少。结论　硝酸甘油预处理能能明显减轻心肌细胞凋亡程度 ;其机制可能与下调 Fas基因蛋白及 m RNA表达有关。     

心力衰竭的心肌细胞凋亡及调控

细胞凋亡是人体组织细胞普遍存在的一种生理现象，细胞凋亡现象也存在于心力衰竭、心肌病、心律失常、冠脉疾病、Ｑ－Ｔ间期延长综合征，缺血再灌注损伤等心血管疾病中，心肌细胞凋亡参与了心力衰竭的敢心肌细胞数量的减少，加剧了心力衰竭。本文简述了心肌细胞凋亡在心力衰竭中的意义及其诱导因素，基因调控，以及对心力衰竭治疗的意义 。     

氯沙坦和卡维地洛对缺血再灌注心肌细胞凋亡的影响

目的 :研究氯沙坦和卡维地洛对缺血再灌注心肌细胞凋亡的影响 ,比较氯沙坦和卡维地洛对缺血再灌注心肌损伤的保护作用。方法 :结扎Wistar大鼠左冠状动脉前降支 ,建立大鼠缺血再灌注动物模型 ,采用原位末端标记细胞凋亡法检测心肌细胞凋亡 ,并利用光学显微镜进行细胞计数。结果 :单纯缺血 再灌注组心肌细胞凋亡数较假手术组明显增多 (37.5 3± 9.2 2 /视野∶0 .18± 0 .0 9/视野 ,P <0 .0 5 ) ,氯沙坦和卡维地洛组心肌细胞凋亡数分别为 8.74± 3.5 1/视野和 7.6 3± 4 .0 5 /视野 ,较单纯缺血 再灌注组明显减少 (P <0 .0 5 ) ,氯沙坦和卡维地洛两组间无明显区别 (P >0 .0 5 )。结论 :氯沙坦和卡维地洛对缺血再灌注心肌细胞损伤具有相似的保护作用 ,可明显减少缺血再灌注心肌细胞凋亡     

缺血后适应对兔心肌细胞凋亡的影响

目的 探讨缺血后适应对兔心肌梗死面积及细胞凋亡的影响.方法 32只成年新西兰雄性大白兔接受缺血30 min再灌注3 h,随机分为缺血再灌注组、缺血后适应组、缺血后适应+wortmannin(PI3K阻滞剂)组、缺血再灌注+wortmannin组.采用Evans蓝和TTC染色的方法确定缺血心肌面积以及梗死心肌面积,采用TUNEL法检测凋亡心肌细胞.结果 与缺血再灌注组比较,缺血后适应组梗死心肌面积百分比及凋亡心肌细胞百分比显著减低(均P<0.05).而在后适应+wortmannin 组无明显减低(P>0.05).结论 缺血后适应可以有效地减少缺血再灌注兔心肌梗死面积细胞凋亡百分比,wortmannin抑制了后适应的作用,提示PI3K的活化在缺血后适应中具有重要作用.     

大鼠心肌再灌注时心肌细胞凋亡,Fas基因表达及缺血预处理对？…

目的 探讨大鼠心肌缺血后不同再灌注时相心肌细胞凋亡,Ｆａｓ基因表达变化及血预处理的影响,方法 １０８只大鼠随分成假手术组（假手术２４小时）缺血３０分钟再灌注６,１２,２４,４８小时组及缺血预处理（ＩＰＣ）组（结扎冠脉５分钟,再灌注５分钟,重复３次后再行结扎冠脉３０分钟,再灌注６小时）口号档端标记法（ＴＵＮＥＬ）标记凋亡细胞,以Ｓ－Ｐ免疫组化及逆转录聚合酶链反应（ＲＴ－ＰＣＲ）法分别检测Ｆａｓ基因蛋     

缺血后适应心肌线粒体能量代谢研究

目的研究缺血后适应心肌线粒体能量代谢特点。方法以Langendofff离体心脏灌注系统构建缺血后适应大鼠模型，随机分为对照组．再灌注组和后适应组，每组16只。平衡20min后，对照组灌注60min;再灌注组停灌30min，再灌注30min；后适应组停灌30min之后，循环6次再灌注10s，停灌10s，再灌注28min。记录心率和冠状动脉流量。冉灌注末取心肌．用高效液相色谱法测定高能磷酸化合物三磷腺苷、二磷腺苷和一磷腺苷含量；用差速离心法提取心肌线粒体，用氧电极法测定线粒体3态呼吸、4态呼吸和线粒体呼吸控制率。结果与再灌注组比较，后适应组明显提高再灌注末的心率和冠状动脉流量，明显提高心肌内二磷腺苷和一磷腺苷含量，三磷腺苷在各组差异无统计学意义。线粒体3态呼吸和线粒体呼吸控制率改善。结论心肌线粒体能量代谢改善，是缺血后适应心肌保护的可能机制之一。     

大鼠离体心脏急性冬眠心肌模型的建立

利用悬浮人类红血球的改良K-H液灌流大鼠离体等容收缩心脏,建立了急性冬眠心肌模型,缺血期间冠状动脉流量下降80%.结果表明,缺血30分钟时,左室内收缩峰压、dp/dt max、—dp/dt max分别降到对照组的44%、33%和26%(P均<0.05),缺血期间保持恒定,再灌注30分钟完全恢复.缺血90分钟,心肌ATP、磷酸肌酸(Crp)及糖原含量明显降低(P均相似文献   

Brief ischemia-reperfusion performed after prolonged ischemia (ischemic postconditioning) can terminate reperfusion arrhythmias with no reduction of cardiac function in rats

OBJECTIVE: Recently, it has been reported that ischemic postconditioning, a brief episode of ischemia-reperfusion performed after prolonged ischemia, can reduce ischemic myocardial injury. However, the effects of ischemic postconditioning on ischemia/reperfusion injury remain unclear. We investigated the effects of brief ischemia-reperfusion before (ischemic preconditioning) and after (ischemic postconditioning) prolonged ischemia on myocardial ischemia/reperfusion injury, especially reperfusion arrhythmias. METHODS: Adult male Sprague-Dawley rats weighing about 400-500 g were used. The isolated heart was perfused using a working heart method (Krebs-Henseleit bicarbonate buffer). In the control group, after stabilization, diastolic global ischemia for 15 minutes was produced by a one-way ball valve with electrical pacing (330 bpm, 2.0 V). After ischemia, the heart was reperfused for 20 minutes. In the preconditioning and postconditioning groups, 5-minute global ischemia was produced before and after ischemia for 15 minutes with a 1 minute interval. An electrocardiogram was performed and left ventricular pressure (LVP, +dP/dt, -dP/dt) and CK activity in coronary effluent were measured during the protocol. RESULTS: Ischemic preconditioning did not affect the incidence or duration of reperfusion ventricular arrhythmias. Ischemic postconditioning could terminate reperfusion ventricular arrhythmias completely and reduced the duration of reperfusion ventricular arrhythmias significantly (P < 0.01). Furthermore, the recovery ratio of +dP/dt at 20 minutes after initial reperfusion was significantly higher in the postconditioning group than in the other groups. CONCLUSION: These results suggest that ischemic postconditioning can terminate reperfusion arrhythmias with no reduction of cardiac function, and may be useful for correcting stunned myocardium.     

Recovery of the heart after normothermic ischemia. Part II: Myocardial function during postischemic reperfusion.

Contraction and relaxation of the canine myocardium were examined during normothermic ischemia in an isolated heart model. Decrease in the development of tension depends on the duration of ischemia. Deficient functional recovery was observed after ischemic periods extending beyond 30 minutes, in spite of reperfusion periods of over 1 hour. A decrease in compliance was observed during the anoxic period, but a persistent defect of relaxation occurred only after 60 minutes of ischemia. After this period there was also a disturbance in the autoregulative mechanisms of coronary perfusion and an uncoupling of O2-consumption and mechanical efficiency. A prolonged reperfusion period of the heart beating empty allowed ultrastructural recovery of the damaged myocardium. In contrast, functional recovery of the myocardium, as determined by several parameters of contraction and relaxation, did not correlate with ultrastructural recovery and was not improved by prolonged reperfusion.     

Slowly inactivating component of sodium current in ventricular myocytes is decreased by diabetes and partially inhibited by known Na(+)-H(+)Exchange blockers

Recent evidence has suggested a major role for a slowly inactivating component of Na(+)current (I(NaL)) as a contributor to ischemic Na(+)loading. The purposes of this study were to investigate veratrine and lysophosphatidylcholine (LPC)-induced I(NaL)in single ventricular myocytes of normal and diabetic rats and to analyse the effects on this current of three pharmacological agents, known as Na(+)/H(+)exchange inhibitors, whose selectivity has been questioned in several studies. A decrease in Na(+)/H(+)exchange activity has been previously shown to be associated with diabetes, and this has been found to confer some protection to the diabetic heart after an episode of ischemia/reperfusion. Recordings were made using the whole-cell patch-clamp technique. I(NaL)was stimulated either by veratrine (100 mg/ml) or by LPC (10 micromol/l) applied extracellularly. Veratrine as well as LPC-induced I(NaL)was found to be significantly decreased in ventricular myocytes isolated from diabetic rat hearts. Veratrine- and LPC-induced I(NaL)in ventricular myocytes of normal rats was significantly (in the range 10(-7)to 10(-4)mol/l) inhibited by the Na(+)/H(+)exchange blockers HOE 694, EIPA and HOE 642. HOE 694 was the most potent inhibitor, followed by the amiloride derivative EIPA and HOE 642. The sensitivity of veratrine-induced I(NaL)to inhibition by HOE 694 and EIPA was markedly reduced in diabetic ventricular myocytes, with no observed inhibition by HOE 642. These data may have important implications as to the protection that may be afforded against ischemic and reperfusion injury, especially during ischemia and when ischemia occurs in a diabetic situation.     

Protective effect of probucol on ischemia-reperfusion arrhythmias in the rat heart.

OBJECTIVE: To evaluate the efficacy of probucol on ischemia-reperfusion injury in the isolated working rat heart. DESIGN: Twelve male Sprague-Dawley rats were divided into two groups: one was fed normal chow (group C) and the other was fed chow containing 1% probucol for four weeks (group P). Samples of heart organ and blood were then taken under anesthesia. Isolated hearts were perfused in a working heart model. After 5 mins of perfusion in aerobic conditions, global ischemia was induced for 15 mins, the hearts were then reperfused. Aortic and coronary flow, cardiac function and electrocardiogram were monitored throughout the experiment, including a 20 min period of reperfusion. Serum lipids and lipid peroxide were also measured in each rat. RESULTS: Rats in group P (probucol-treated) had significantly lower levels of serum cholesterol, triglyceride and phospholipid than those in group C (controls). Serum lipid peroxide was also significantly lower in group P than in group C rats (P < 0.05). The incidence of ventricular arrhythmias in the ischemia and reperfusion stages was lower in group P than in group C (P < 0.001) and the increase in coronary flow during the reperfusion stage was greater in isolated hearts of group P rats than in those of group C (P < 0.05). CONCLUSIONS: Probucol may have a protective effect on myocardium with respect to ischemia-reperfusion arrhythmia in the isolated rat heart, presumably due to an antioxidative effect.     

Quantification of hydroxyl radical and its lack of relevance to myocardial injury during early reperfusion after graded ischemia in rat hearts.

To elucidate the pathophysiological role of the hydroxyl radical (.OH) during the postischemic reperfusion of the heart, we measured the .OH product in the coronary effluent from isolated perfused rat heart during a 30-minute reperfusion period after various ischemic intervals of 5, 10, 15, 20, 30, and 60 minutes. Salicylic acid was used as the probe for .OH, and its derivative, 2,5-dihydroxybenzoic acid (2,5-DHBA), was quantified using high-performance liquid chromatography with ultraviolet detection. 2,5-DHBA was negligible in the effluent from nonischemic hearts, but a significant amount was detected from the hearts rendered ischemic for 10 minutes or longer. The peak of 2,5-DHBA was seen within 90 seconds after the onset of reperfusion in every group. The accumulated amount of 2,5-DHBA was maximal in the group with 15-minute ischemia (6.73 +/- 1.04 nmol/g wet heart wt after 30 minutes of reperfusion); it decreased as the ischemic time was prolonged and was 2.38 +/- 0.84 nmol/g wet wt after 30 minutes of reperfusion in the group with 60-minute ischemia. In the model of 15-minute ischemia/30-minute reperfusion, there was no correlation between the accumulated amount of 2,5-DHBA and functional recovery (+/- dP/dt, heart rate, and coronary flow), lactate dehydrogenase release, and morphological damage. Although treatment with 0.5 mM deferoxamine, an iron chelator, significantly decreased 2,5-DHBA (from 6.73 +/- 1.04 to 2.29 +/- 0.80 nmol/g wet wt after 30 minutes of reperfusion, p less than 0.01), it failed to reduce the postischemic myocardial injury in the group with 15-minute ischemia. The results suggest that .OH production is influenced by the preceding ischemic interval and that .OH does not exert an immediate direct effect on postischemic damage during early reperfusion in the isolated perfused rat heart, although a possibility remains that the small portion of .OH trapped by salicylic acid may not be intimately associated with myocardial injury.     

Effects of reperfusion on myocardial wall thickness, oxidative phosphorylation, and Ca2+ metabolism following total and partial myocardial ischemia

Coronary artery reperfusion following acute myocardial ischemia may salvage ischemic jeopardized cells. We studied the effects of early brief reperfusion on totally ischemic and on partially ischemic myocardium of open-chest pigs. In 10 animals, coronary flow was reduced to 0% for 30 minutes and was followed by 10 minutes reperfusion (group A). In another 10 animals, coronary flow was reduced to 25% of the baseline value for 30 minutes followed by 10 minutes of reperfusion (group B). In another eight animals coronary flow was reduced to 25% of the baseline value for 60 minutes and followed by 10 minutes of reperfusion (group C). Results showed that a brief 10-minute period of reperfusion of ischemic myocardium after total occlusion caused abnormal diastolic wall thickening with only partial return of systolic wall thickening. However, reperfusion of ischemic myocardium after partial occlusion, whether 30 or 60 minutes, caused little diastolic wall thickening and a partial return of systolic thickening. A marked elevation of myocardial Ca2+, a decrease in mitochondrial adenosine triphosphate (ATP) production and cellular ATP concentration, and a reduction in the rate of Ca2+ uptake by sarcoplasmic reticulum vesicles occurred in the totally ischemic myocardium but not in the partially ischemic myocardium. These results demonstrate that reperfusion of ischemic myocardium after 1 hour of coronary flow reduction to 25% of baseline is less damaging than reperfusion after a 30-minute total coronary occlusion, and suggest that preexisting states affecting coronary flow need to be evaluated in assessing the outcome of reperfusion.     

Free radicals and reperfusion-induced arrhythmias: protection by spin trap agent PBN in the rat heart

Using the isolated perfused rat heart with transient (10-minute) regional ischemia induced by coronary artery ligation, we have shown that PBN (N-tert-butyl-alpha-phenylnitrone), an organic spin trap agent designed specifically to form "stable" adducts with free radicals in electron spin resonance studies, can dramatically reduce the vulnerability of the myocardium to reperfusion-induced ventricular fibrillation. Studied in the concentration range of 5-1,000 microM/L, PBN added to the perfusate 5 minutes prior to ischemia exerted a dose-dependent protective effect. At the optimum concentration of 30 microM/L PBN reduced the incidence of ventricular fibrillation to 50% (6 of 12) from its control value of 100% (12 of 12). The antiarrhythmic effect was achieved without any substantial effect on coronary flow or heart rate. Investigating whether this was a direct antiarrhythmic effect, operating during reperfusion, or an indirect effect arising from the action of PBN on the heart during ischemia, PBN (30 microM/L) was added to the perfusion fluid 2 minutes before reperfusion. In the control group, 100% of the hearts fibrillated whereas only 50% fibrillated in the PBN group. Additional studies were designed to ascertain whether the drug caused an absolute reduction in vulnerability to reperfusion-induced arrhythmias (irrespective of the duration of ischemia) or whether it only shifted the ischemic time-reperfusion vulnerability curve to the right (i.e., delayed the onset of vulnerability). Thus, studies were undertaken to define the relation between the duration of ischemia and the incidence of reperfusion-induced arrhythmias in control hearts and hearts treated with PBN.(ABSTRACT TRUNCATED AT 250 WORDS)     

Direct detection of free radicals in the reperfused rat heart using electron spin resonance spectroscopy

The purpose of this study was to use a direct method, that of electron spin resonance (ESR) spectroscopy, to demonstrate that reperfusion after a period of ischemia results in a sudden increase in the production of free radicals in the myocardium. The isolated buffer-perfused rat heart was used with N-tert-butyl-alpha-phenylnitrone (PBN) as a spin-trapping agent. Samples of coronary effluent were taken and extracted into toluene for detection of radical adducts by ESR spectroscopy. After 15 minutes of total, global ischemia, aerobic reperfusion resulted in a sudden burst of radical formation that peaked at 4 minutes. When hearts were reperfused with anoxic buffer, no dramatic increase in radical production was observed. Subsequent reintroduction of oxygen, however, resulted in an immediate burst of radical production of a similar magnitude to that seen in the wholly aerobic reperfusion experiments. The ESR signals obtained (aN = 13.60 G, aH = 1.56 G) are consistent with the spin-trapping by PBN of either a carbon-centered species or an alkoxyl radical, both of which could be formed by secondary reactions of initially-formed oxygen radicals with membrane lipid components.