RESUMO
The influence of glucose-insulin-potassium infusion in combination with a mechanical assist device (intraaortic balloon pumping, IABP) on the levels of high energy phosphates in the canine heart after coronary artery ligation was compared with the effect of a separate application of these measures to protect the acute ischaemic myocardium. The combined method normalized the tissue content of creatine phosphate in the nonischaemic tissue contrary to the application of the mechanical or pharmacological assistance alone. In the ischaemic cardiac tissue only the combination of both methods reduced the loss of creatine phosphate, ATP and the sum of adenine nucleotides. With the balloon pumping a reduction in lactate accumulation was achieved, which, however, was significantly lower than that obtained by the combination of heart protective measures: IABP plus glucose-insulin-potassium.
Assuntos
Doença das Coronárias/terapia , Glucose/uso terapêutico , Insulina/uso terapêutico , Balão Intra-Aórtico , Potássio/uso terapêutico , Nucleotídeos de Adenina/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Doença das Coronárias/tratamento farmacológico , Vasos Coronários/fisiologia , Cães , Quimioterapia Combinada , Feminino , Ventrículos do Coração/metabolismo , Cinética , Lactatos/metabolismo , Masculino , Miocárdio/metabolismo , Fosfocreatina/metabolismo , Piruvatos/metabolismoRESUMO
The authors examined the effects of reperfusion after temporary ischemia in 50 dogs. The morphologic alterations were documented by methods of electron microscopy, fluorescence microscopy, and histochemistry. Lactate and activity of glycogen phosphorylase were assessed. According to the results, the optimal ischemia interval is 30 to 60 minutes for rational application of reperfusion, while it is just possible after 120 minutes. After a 4-hours-period of ischemia reperfusion increase morphologic damage of myocardium and impairment of myocardial metabolism. Prolonged reperfusion of 7 days resulted in a reduced extent of infarction compared with controls. In non-ischemic myocardium the morphologic and metabolic alterations were less expressed. The effects of "no-reflow"-phenomenon and conclusions for clinical practice are discussed.
Assuntos
Infarto do Miocárdio/cirurgia , Animais , Vasos Coronários , Cães , Isquemia , Dilatação Mitocondrial , Perfusão , Fatores de TempoRESUMO
Enzyme-histochemical changes due to temporary ischemia of canin heart muscle with subsequent reperfusion of the ischemic damaged muscle are described. In relation to findings in the rat, the first enzyme-histochemical changes were observed after two hours of coronary artery ligation. These changes were more impressive after 4 hours of ligation. A further increase was caused by the reperfusion.