Pre-and Post-ishemic Changes of the Constituent Enzymes in Isolated Rabbit's Myocardium / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Nucleoside transport inhibitor(NTI) Keeps AMP, ADP, ATP levels high in myocytes by inhibiting adenosine cataboilsm so that it may preserve the myocardial contractability during ischemia In this study we investigated the effects of cyclic AMP phosphodiesterase inhibor(C-AMP PDSI) and S-P-nitrobenzyl-6 -thioniosine(NBT; a sort of NIT) on myocadial preservation and changes of constituent enzyme. MATERIAL AND METHOD: Twenty-six isolated rabbit hearts were perfused with Krebs-Henseleit buffer solution for 20 minutes arrested for 20 minutes and ten reperfused for 30 minutes. The following four groups were prepared and hemodynamic changes coronary effluent lactate dehydrogenase (LDH) a-hydroxybutylic accid(a-HBD) levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels and myocardial LDH creatine kinase-MB (CK-MB) adenosine deaminase(ADA) a-HBD levels were analysed before and after cardiac arest ; Group I(control) ; the heart was only perfused with K-H ; Group II ; the heart was perfused with K-H including C-AMP PDSI(Amrinone 25mg/L); Group III ; the heart was perfused with K-H including NBT(4.19mg/L) ; Group IV ; the heart was perfused with K-H including C-AMP PDSI + NBT. RESULT: Left venticular developed pressure(LVDP) at 10 minutes of the equilibrium was significantly higher in group III(72.1+/-5.3 mmHg p<0.01) and group III(72+/-5.6 mmHg P<0.025) as compared with group I (40.8+/-4.7mmHg) and LVDP at 20 minutes of the reperfusion was significantly higher in group II(74+/-5.3mmHg P<0.01) and group III(72+/-5.6mmHg p<0.025) as compared with group I (44.2+/-4.6mmHg). Percentage recovery of LVDP at the reperfusion was the highest in group II(123.3%) Percentage recovery of coronary flow at the equilibrium reperfusion were higher in group II(310%, 270%) group III(230%, 290%) group IV(310%, 280%) as compared with group I (100%) respectively. Myocadial LDH level was significant lower in group IV(33495+/-1802 IU/gm p<0.04) as compared with group I(48767+/-1421 IU/gm) Myocadial CK-MB level was significant higher in group II(74820+/-1421 IU/gm) compared with group I 45450+/-1737 IU/gm) Myocadial ADA level was significant higher group IV(1215+/-8 IU/gm p<0.05) compared with group I(125+/-15 IU/gm) but there was no significant difference between group I and group II ,III, IV in changes of coronary effluent LDH, a-HBD levels. CONCLUSIONS: C-AMP PDSI solely appears to have a better effect on myocardial preservation after ischemia than NBT but with no synergistic effect and it could keep CK-MB leve high in myocardial tissues.