心筋硬塞に対するglucagonの効果 : 実験的心筋硬塞犬における血行動態におよぼす影響

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Glucagon, a polypeptide hormone produced chiefly by the alpha cells of the pancreas, has been used clinically for the treatment of heart failure and cardiogenic shock because of its positive inotropic capabilities. In almost of the previous investigations, glucagon in dosis of 50-70μg/Kg was infused in the patient by an infusion pump over a two minute period and the evaluation of its effects was carried out with maximum response of hemodynamics. However, peak effect of glucagon infusion was only between 10 and 15 minutes, and the previous evaluation of effects of glucagon had some problems on the special case who needs prolonged effect of glucagon. In the preliminary study, the authors found that glucagon (50μg/Kg) produced a serious tachycardia in the dogs. The purpose of this study was done to determine the adequate method and dose of glucagon administration for the treatment of hemodynamical disorders in acute myocardial infarction, cardiogenic shock. Material and Method Twenty-five mogorel dogs, weighing from 7 to 14Kg, were anesthetized with intravenous sodium pentobarbital (25/Kg). An intratracheal tube was inserted and ventilation was carried out by a piston type respilator with room air. The heart was exposed by 4th intercostal thoracotomy. Myocardial infarction was produced by serial ligations of branches of the left circumflex coronary artery until a drop in the femoral arterial systolic pressure between 60 and 70% of the initial value was observed. Four dogs were died of serious arrythmia and cardiogenic shock soon after the ligation of the coronary artery and were rejected. Thirty minutes after the ligation of the coronary artery, glucagon (10μg/Kg) was administered intravenously as one shot over a two minute period in 5 dogs and glucagon (3-5 μg/Kg) in 6 dogs, and a continuous intravenous infusion in dosis of 0.5 μg/Kg/min was continued for I hours in 5 dogs. Heart rate, femoral arterial pressure, central venous pressure, cardiac output and left ventricular dp/dt were recorded with multipurpose polygraph (RM-150, Nihonkoden) before and 30 minutes after ligation of the coronary artery, and then 10 and 60 minutes after glucagon administration. Cardiac index (ml/Kg), stroke index (ml/Kg), left ventricular work and total peripheral vascular resistance were calculated.
社団法人日本循環器学会の論文
1973-10-20

心筋硬塞に対するglucagonの効果 : 実験的心筋硬塞犬における血行動態におよぼす影響

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