阿托伐他汀对兔急性心肌梗死再灌注后一氧化氮、内皮素-1水平及心功能的影响

目的:评价阿托伐他汀对兔急性心肌梗死再灌注(AMI/R)后一氧化氮(NO)、内皮素-1(ET-1)水平的影响及对心功能的作用。方法:新西兰大白兔24只随机分成AMI/R组、阿托伐他汀治疗组(5mg·kg-1.d-1)和假手术组,每组8只。冠状动脉结扎60min,松解120min制备AMI/R模型。梗死前、后和再灌注后均行血流动力学测定,采用硝酸还原酶法检测血浆及心肌组织NO水平,采用放射免疫方法测定血浆及心肌组织ET-1水平。结果:(1)与AMI前相比较,AMI/R组AMI60min和再灌注后120min,心率(HR)、主动脉收缩压(SBP)和舒张压(DBP)、左室收缩压(LVSP)、左心室内压最大收缩和舒张变化速率(±dp/dtmax)及心排量(CO)均显著下降,左室舒张末压(LVEDP)显著升高(P0.05或P0.01)。与AMI前相比,阿托伐他汀治疗组AMI60min和再灌注后120min上述各项指标变化与AMI/R组的变化趋势相似(P0.05或P0.01),但再灌注后120minLVSP、LVEDP、±dp/dtmax及CO比AMI60min有显著恢复(P0.01),且比AMI/R组恢复更显著(P0.05或P0.01);另外,治疗组SBP、DBP下降幅度明显低于AMI/R组(P0.01)。(2)与AMI/R组相比,阿托伐他汀能使AMI再灌注后血浆NO水平显著升高,ET-1水平显著降低(P0.01);而心肌组织NO、ET-1的含量治疗组仅复流区显著降低(P0.05或P0.01)。(3)与AMI/R组相比,阿托伐他汀可促进AMI后心功能的恢复。结论:阿托伐他汀能使缺血再灌注后血浆及心肌NO水平显著升高,ET-1水平显著降低,具有内皮保护作用;可促进AMI后心功能的恢复。

Effects of atorvastatin on nitric oxide,endothelin-1 and myocardial function in a rabbit model of acute myocardial infarction and reperfusion

AIM: To evaluate the effects of atorvastatin on nitric oxide(NO), endothelin-1(ET-1)and myocardial no-reflow in a rabbit model of acute myocardial infarction and reperfusion(AMI/R). METHODS: Twenty-four rabbits were randomized into 3 groups: 8 in AMI/R group, 8 in atorvastatin-treated group(5 mg·kg-1·d-1)and 8 in sham-operated group. Animals in the former two groups were subjected to 60 min of coronary occlusion followed by 120 min of reperfusion. Data on haemodynamics were collected. NO in blood sample, and in normal, and in infarcted reflow and no-reflow myocardium were evaluated respectively by nitrate reductase method. The levels of ET-1 in blood sample, and in normal, infarcted reflow and no-reflow myocardium were determined by radioimmunoassay. RESULTS: (1)Compared to the baselines, the heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), left ventricular systolic pressure(LVSP), maximal rate of increase and decline in left ventricular pressure(±dp/dtmax)and cardiac output(CO)in AMI/R and atorvastatin-treated groups were significantly declined, whereas left ventricular end-diastolic pressure(LVEDP)was increased after 60 min of coronary occlusion and 120 min of reperfusion(P<0.05 or P<0.01). However, in atorvastatin-treated group, LVSP, LVEDP, ±dp/dtmax and CO at the time point of 120 min of reperfusion recovered more significantly than those at the time point of 60 min of coronary occlusion(P<0.01), which was more significant than those in AMI/R group(P<0.05 or P<0.01). Compared to AMI/R group, the SBP and DBP were significantly heigher in atorvastatin-treated group(P<0.01).(2)In atorvastatin-treated group, the levels of ET-1 in blood sample were significantly lower than those in AMI/R group(P<0.01), and the levels of NO were significantly higher(P<0.01). Moreover, the levels of NO or ET-1 in infarcted reflow myocardium were significantly lower than that in AMI/R group(P<0.05 or P<0.01).(3)Atorvastatin could ameliorate myocardial function. CONCLUSION: Atorvastatin is effective in increasing NO and reducing ET-1 in blood plasma and local myocardium, and in protection of endothelial cells. Atorvastatin also has a beneficial effect on improving left ventricular function during acute myocardial infarction and reperfusion in rabbits.