Dose-dependent Effects of Esmolol-epinephrine Combination Therapy in Myocardial Ischemia and Reperfusion Injury.
Curr Pharm Des
; 25(19): 2199-2206, 2019.
Article
em En
| MEDLINE
| ID: mdl-31258066
ABSTRACT
BACKGROUND:
Animal studies on cardiac arrest found that a combination of epinephrine with esmolol attenuates post-resuscitation myocardial dysfunction. Based on these findings, we hypothesized that esmololepinephrine combination therapy would be superior to a reported cardioprotective esmolol therapy alone in a mouse model of myocardial ischemia and reperfusion (IR) injury.METHODS:
C57BL/6J mice were subjected to 60 min of myocardial ischemia and 120 min of reperfusion. Mice received either saline, esmolol (0.4 mg/kg/h), epinephrine (0.05 mg/kg/h), or esmolol combined with epinephrine (esmolol 0.4 mg/kg/h or 0.8 mg/kg/h and epinephrine 0.05 mg/kg/h) during reperfusion. After reperfusion, infarct sizes in the area-at-risk and serum cardiac troponin-I levels were determined. Hemodynamic effects of drugs infused were determined by measurements of heart rate (HR) and mean arterial blood pressure (MAP) via a carotid artery catheter.RESULTS:
Esmolol during reperfusion resulted in robust cardioprotection (esmolol vs. saline 24.3±8% vs. 40.6±3% infarct size), which was abolished by epinephrine co-administration (38.1±15% infarct size). Increasing the esmolol dose, however, was able to restore esmolol-cardioprotection in the epinephrine-esmolol (18.6±8% infarct size) co-treatment group with improved hemodynamics compared to the esmolol group (epinephrine-esmolol vs. esmolol MAP 80 vs. 75 mmHg, HR 452 vs. 402 beats/min).CONCLUSION:
These results confirm earlier studies on esmolol-cardioprotection from myocardial IR-injury and demonstrate that a dose optimized epinephrine-esmolol co-treatment maintains esmolol-cardioprotection with improved hemodynamics compared to esmolol treatment alone. These findings might have implications for current clinical practice in hemodynamically unstable patients suffering from myocardial ischemia.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Propanolaminas
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Traumatismo por Reperfusão
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Epinefrina
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Isquemia Miocárdica
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article