Nifekalant Hydrochloride Administration During Cardiopulmonary Resuscitation Improves the Transmural Dispersion of Myocardial Repolarization : Experimental Study in a Canine Model of Cardiopulmonary Arrest
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概要
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Background Because nifekalant hydrochloride (NIF) displayed a superior defibrillating effect on ventricular tachycardia/fibrillation (VT/VF) in cardiopulmonary arrest (CPA) patients, despite some QT prolongation, its effect on transmural dispersion of repolarization (TDR) in the left ventricle (LV) in an animal model of CPA was investigated. Methods and Results Eight beagle dogs were created with a myocardial infarction under anesthesia, and then VT/VF induction by continuous stimulation and cardiopulmonary resuscitation (CPR) were repeated. NIF (0.3mg/kg) was administered under acidotic conditions (pH 7.26). The QTc interval measured by Y-lead ECG showed no significant prolongation before and after NIF. The activation recovery interval (ARI) measured by 64-lead LV surface mapping showed minimum ARI prolongation (40%) by NIF without maximum ARI prolongation, and as a result the ARI dispersion decreased by 67%. The repolarization time (RPT) with the plunge electrode showed 13-19% prolongation in the subendocardium and subepicardium with CPR, but NIF prolonged the RPT in the middle layer alone (17%), and as a result Plunge-TDR decreased by 82% (n=8, p<0.05). Conclusions Administration of NIF during CPR decreased the TDR by RPT prolongation selectively in the middle layer. Because the subendocardial and subepicardial RPTs after CPR were already prolonged before NIF administration, it may have been the reason why the QT-prolonging effect of NIF was not reflected in the body surface ECG.
- 2006-08-20
著者
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Kodama Itsuo
Research Institute of Environmental Medicine, Nagoya University
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Amino Mari
Department of Cardiology, Tokai University School of Medicine
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Aikawa Minoru
Division Of Cardiology Tokai University School Of Medicine
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Amino Mari
Department Of Cardiology Tokai University School Of Medicine
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Ikari Yuji
Department of Cardiology, Tokai University School of Medicine
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Yoshioka Koichiro
Department of Cardiology, Tokai University School of Medicine
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TANABE Teruhisa
Division of Cardiology, Tokai University School of Medicine
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Matsuzaki Atsushi
Department of cardiology, Tokai University
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Tanabe Teruhisa
Department of cardiology, Tokai University
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Usui Kazutane
Department of Cardiology, Tokai University
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Deguchi Yoshiaki
Department of Cardiology, Tokai University
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Kodama Itsuo
Research Institute For Environmental Medicine Nagoya University
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Ikari Yuuji
Tokai University
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Ikari Yuji
Department Of Cardiology Tokai University School Of Medicine
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Ikari Yuji
Division Of Cardiology Tokai University School Of Medicine
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Kanda Shigetaka
Department of Cardiology, Tokai University School of Medicine
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Kanda Shigetaka
Department Of Cardiology Tokai University School Of Medicine
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Matsuzaki Atsushi
Tokai University School of Medicine
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Kozuma Kumiko
Tokai University School of Medicine
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Kohzuma Kumiko
Department of Cardiology, Tokai University School of Medicine
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Tanabe Teruhisa
東海大学 医学部循環器内科
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Sugimoto Atsuhiko
Department of Cardiology, Tokai University School of Medicine, Nagoya University
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Sugimoto Astuhiko
Departmentof Cardiology Tokai University School Of Medicine
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Ikari Yuji
Department Of Cardiology Tokai University Hospital
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Usui Kazutane
Department Of Cardiology Tokai University School Of Medicine Nagoya University
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Deguchi Yoshiaki
Department Of Cardiology Tokai University School Of Medicine
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Kohzuma Kumiko
Department Of Cardiology Tokai University School Of Medicine Nagoya University
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Ikari Yuji
Department Of Cardiovascular Medicine Tokai University School Of Medicine
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Yoshioka Kouichirou
Department Of Cardiology Tokai University School Of Medicine
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Yoshioka Koichiro
Department Of Cardiology Tokai University School Of Medicine
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Matsuzaki Atsushi
Department Of Cardiology Tokai University School Of Medicine
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Tanabe Teruhisa
Department Of Cardiology School Of Medicine Tokai University
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Kohzuma Kumiko
Division Of Cardiology Tokai University School Of Medicine
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Kohzuma Kumiko
Department Of Cardiology Tokai University Hospital
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Ikari Yuji
Department Of Cardiology Tokai University School Of Medicine Nagoya University
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Ikari Yuji
Departments Of Cardiology
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Sugimoto Atsuhiko
Department Of Cardiology Tokai University School Of Medicine Nagoya University
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Tanabe Teruhisa
Department Of Medicine Tokai University Hospital
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Ikari Yuji
Division Of Cardiology Mitui Memorial Hospital
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Tanabe Teruhisa
Department Of Internal Medicine
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Kohzuma Kumiko
Department Of Cardiology Tokai University School Of Medicine
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Ikari Yuji
Department Of Cardiology Tokai Univeristy
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Yoshioka Koichiro
Department Of Cardiology Tokai University Hospital
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Yoshioka Koichiro
Department Of Cardiovascular Medicine Tokai University School Of Medicine
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