<Originals>Basic and Clinical Studies of Cardioplegia on Myocardial Metabolism

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概要

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• Effects of various cardioplegic solution and myocardial temperature on myocardial protection were evaluated by using indicators such as NADH-fluorometry, reservation ratio of intramyocardial ATP, water content and left ventricular function curves in hypertrophic (SHR) and non-hypertrophic hearts in WKY rats and dogs. Myocardial damage during ischemia was also studied from the tissue injuries due to both myocardial anoxia and reperfusion. In WKY, permissible myocardial ischemic time was 45 minutes at 36℃ ; in contrast, it could be prolonged to 210 minutes at 20℃ by using cold blood cardioplegia (CBC). In SHR, the permissible myocardial ischemic time was approximately 70-80% of that in WKY. Reservation ratio of the intramyocardial ATP was greatest in Group CBC and least in Group glucose insulin potassium (GIK) in dogs. CBC led to the best recovery of left ventricular stroke work. Water content was least in Group CBC, and increased in order of Kinki University Solution (KUS), GIK and ventricular fibrillation. Post-ischemic hyperoxidation was detected by NADH-fluorometry at the reperfusion 60 minutes after ischemia at 36℃. Thiobarbituric acid reactive substance, probably due to the production of lipid peroxide, was recognized after the initiation of reperfusion following coronary occlusion for 120 minutes at 36℃. The clinical results revealed that CBC has safer and more efficient myocardial protective effect with the low mortality and the low incidence requiring inotropic agents after operation than does ventricular fibrillation.

• 1984-12-28

著者

• NISHIOKA Takazumi

  Department of Cardiovascular Surgery, Kinki University School of Medicine

• Nishioka Takazumi

  Department Of Cardiovascular Surgery Kinki University School Of Medicine

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