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AN EXPERIMENTAL STUDY ON THE ADDITIONAL MYOCARDIAL PROTECTIVE EFFECT OF ADENOSINE TRIPHOSPHATE AND NIFEDIPINE IN CARDIOPLEGIC SOLUTION

English (英語)

The Kobe journal of the medical sciences

34(6)

285-302

1988-12

The potential protective effect on the ischemic myocardium of adenosine triphosphate (ATP) and nifedipine added to St. Thomas's Hospital cardioplegic solution was investigated by using isolated and perfused working rat heart model. Dose-response study with ATP ranging between 2.0 and 8.0 mmol/L showed 4.0 mmol/L to be the optimal concentration for recovery of aortic flow after 35 minutes of normothermic (37°C) ischemic arrest. Aortic flow after reperfusion remained at 50. 3±5. 3% of preishemic value in the ATP-free control group, whereas it recovered to 87.7±1.9% of preischemic value (p<0.001) and CPK leakage was reduced by 84% (p<0.01) in the ATP group. At its optimal concentration (4.0 mmol/L), ATP as well as ATP-MgC12 (1:1) as an additive to the K cardioplegic solution showed improved recovery of aortic flow to 71.5±1.5% (p<0.05) and to 80.3±1.4% (p<0.001) of the preischemic value, respectively. The myocardial protection of ATP-MgC12 was better than ATP alone (P<0.001). Dose-response study with nifedipine ranging between 0.2 and 1.0 mg/L showed 0.4 mg/L to be the optimal concentration for recovery of aortic flow after 35 minutes of normothermic ( 37°c) ischemic arrest. Aortic flow after reperfusion remained at 50. 3±5. 3% of preischemic control value in the nifedipine-free control group, but it recovered to 89.0±1.2% of preischemic control value in the nifedipine group (p<0.001). CPK leakage was reduced by 81% (p<0.01) by adding nifedipine to the ordinary St. Thomas' Hospital cardioplegic solution. The combined effects of ATP and ninedipine were evaluated by adding them to the St. Thomas' Hospital cardioplegic solution as well as K cardioplegic solution. The result showed that ATP and nifedipine added to the K cardioplegic solution in combination resulted in a greater protection; namely, while the recovery of aortic flow after reperfusion remained at 87.8±1.9% of preischemic value in the ATP alone group and at 89.0±1.2% in the nifedipine alone group, it increased to 93. 7±1.1% in the combination group. In conclusion, ATP and nifedipine markedly improved the myocardial protecting properties of St. Thomas' Hospital cardioplegic solution during 35 minutes of normothermic (37°c) ischemic arrest.

isolated and perfused working rat heart model

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