Mycrocardial protection by verapamil and reperfusion following coronary occlusion

RESUMO

The hypothesis that early verapamil (VP) treatment in acute myocardial ischemia can enhance the effects of subsequent reperfusion was tested in open-chest dogs submitted to 3h of left anterior descending artery occlusion and 2 h of reperfusion. 2. Arterial pressure and heart rate were monitored continuosusly. The area at risk (AR) was deteminede by left injection of99 technetium-labeled microspheres soon after occlusion. The area of necrossis (AN) was indentified histologically with triphenyl tetrazolium chloride and calculated as percent of Ar. Myocardial preservation is reported as percent of AR spared from necrosis (AR-An) x 100/AR). 3. Fouteen dogs received 0.2 mg VP, iv, 15 min after occlusion and 9 untreated dogs served as controls. Verapamil signficantly reduced heart rate but did not affect blood pressure or the pressure or the pressure-heart rate product. 4. Myocardial preservation was significantly greater in verapamil-treated dogs than in control animals (51ñ20 vs 31 ñ 19%, mean ñ SD). However, area at risk (%) in the left ventricle was not significantly different in treated and control animals (31 ñ 12 vs 32 ñ 4%). 5. These data indicate that verapamil protects the ischemic myocardium in this occlusion/reperfusion model and that the mecanism of protection is probably related to a non-hemodynamic, metabolic activity of verapamil .