葛根素对急性心肌缺血狗区域性心肌血流与心脏血流动力学的作用
EFFECT OF PUERARIN ON REGIONAL MYOCARDIAL BLOOD FLOW AND CARDIAC HEMODYNAMICS IN DOGS WITH ACUTE MYOCARDIAL ISCHEMIA
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摘要: 麻醉开胸狗ⅳ葛根素(puerarin)可减慢心率(HR)、降低主动脉压(MAP),用同位素标记微球法测得的缺血区侧枝冠脉血流量并不减少。从狗的右室旁路制备的心脏血流动力学实验发现葛根素明显减低张力一时间指数(TTI)与左室压力升高速度(LV dp/dt)。当MAP调整到给药前的水平时,TTI与LV dp/dt恢复,进入缺血区的侧技血流增加,非缺血区的冠脉血流量(CBF)亦增加。葛根素减低冠脉血管阻力(CVR)的作用比减低全身血管阻力(SVR)的作用更显著。葛根素不影响心肌收缩力,但增加局部心肌缺血时的侧枝血流并减少与心肌氧消耗有关的血流动力学参数。这些结果提示葛根素有益于治疗心肌缺血。Abstract: The present study was carried out using 22 anesthetized dogs with reversible ligation of the left anterior descending coronary artery to determine the effects of infused puerarin on collateral blood flow to the ischemic myocardium and on systemic hemodynamics.Intravenous infusion of puerarin(10 mg/kg/min)during acute regional myocardial ischemia was associated with a decrease in heart rate from 174±6 to 149±6 beats/rain (P<0.001) and in mean arterial pressure from 105±9 to 80±8 mmHg (P<0.01). Despite the decrease in mean arterial pressure, collateral coronary blood flow (radiolabelled microspheres) did not decrease.In six right heart bypass experiments in which the hemodynamics were controlled, infusion of puerarin significantly lowered the tension time index and LV dP/ dt. Restoration of systemic blood pressure to the same level that existed prior to the infusion resulted in a substantial increase in collateral flow to ischemic myocardium from 0.55±0.12 to 1.36±0.39 ml/min/g (P<0.05) and in increase in coronary blood flow to nonischemic myocardium from 1.11±0.15 to 4.28±1.01 ml/min/g (P<0.05). The diminution of coronary vascular resistance was approximately twice that of systemic arterial resistance (P<0.025). The stroke work-left ventricular end-diastolic pressure relationship did not change significantly indicating that the infusion of puerarin did not affect myocardial contractility.The results suggest that puerarin lowers resistance to collateral blood flow to regional myocardial ischemia and diminishes the correlates of myocardial oxygen demand both of which would be expected to have a beneficial effect on ischemic rnyocardium. The data support the clinical potential of this agent.
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