<予防および治療>エネルギー枯渇心に対する冠阻血時の心筋保護

概要

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The effect on the energy metabolism of the temperature of blood cardioplegia administered at induction was evaluated with ^<31>P-NMR using rabbit hearts. Adenosine triphosphate (ATP), creatine phosphate (CrP) and inorganic phosphate (Pi) were measured in the isolated rabbit heart. Fifty percent depletion of myocardial ATP was produced by 30 minutes of 37℃ global ischemia in 27 isolated hearts. As the control (n=7), anoxic arrest, initially produced by stopping perfusion and followed by cardioplegic arrest, was continued for 60 minutes with intermittent infusion of 10℃ cold blood cardioplegia. Warm blood cardioplegia at 25℃ (n=5) and 37℃ (n=5) was infused at induction. After 30 minutes reperfusion, recovery of ATP and CrP in the 25℃ group was significantly excellent, compared with that in the 37℃ group and the control group [<CrP> control (93.8±17.9%), 25℃(103.1±13.5%) versus 37℃(71.1±22.6%). <ATP> control (55.7±13.2%), 25℃ (84.7±16.2%) versus 37℃(54.0±16.4%)]. In the control group, CrP was promptly recovered, however, the ATP level did not increase at all. In the 37℃ group, neither CrP nor ATP recovered. Warm blood cardioplegia at induction has a beneficial effect on myocardial metabolic recovery. Particularly, use of warm blood cardioplegic induction at 25℃ improves tolerance to myocardial ischemia in energy-depleted hearts.
近畿大学の論文
1988-12-30