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La cardioplejía sanguínea suplementada con adenosina atenúa la disfunción posisquémica después de una isquemia
V H Thourani1, R S Ronson, D G Van Wylen
1Division of Cardiothoracic Surgery, Department of Surgery, Carlyle Fraser Heart Center-Cardiothoracic Research Laboratory, Crawford Long Hospital of Emory University School of Medicine, Atlanta, GA 30365-2225, USA.
Circulation
|November 24, 1999
Resumen
La adenosina (ADO) administrada durante la reperfusión mejora significativamente la función cardíaca posisquémica y reduce el tamaño del infarto. La suplementación con ADO en la cardioplejía sanguínea (BCP) también reduce el tamaño del infarto, pero no mejora la función endotelial tan efectivamente como la administración de reperfusión.
Área de la Ciencia:
- Ciencias Cardiovasculares Ciencias Cardiovasculares
- Cirugía cardíaca Cirugía cardíaca.
- Farmacología Farmacología.
Sus antecedentes:
- Se sabe que la administración de adenosina (ADO) en cardioplejía reduce la lesión isquémica del miocardio.
- El momento óptimo para la administración de ADO para mitigar la lesión por reperfusión miocárdica sigue siendo objeto de investigación.
- Este estudio explora la eficacia de la cardioplejía sanguínea complementada con ADO (BCP) frente a la ADO durante la reperfusión.
Objetivo del estudio:
- Para probar la hipótesis de que la BCP suplementada con ADO o la ADO administrada durante la reperfusión reduce la disfunción posisquémica después de una isquemia regional grave.
- Evaluar el impacto de las diferentes estrategias de administración de ADO en la función miocárdica y los marcadores de lesión.
Principales métodos:
- Se indujo un modelo canino de isquemia miocárdica regional severa a través de la oclusión de la arteria coronaria descendente anterior izquierda.
- Tres grupos recibieron diferentes tratamientos: BCP sin suplementos, BCP complementado con ADO (ADO-CP) o ADO durante la reperfusión (ADO-R).
- Se evaluó la función posisquémica, el tamaño del infarto, el edema miocárdico y la adherencia de neutrófilos.
Principales resultados:
- ADO-R mejoró significativamente el acortamiento sistólico regional posisquémico en comparación con BCP.
- Tanto ADO-CP como ADO-R redujeron el tamaño del infarto y el edema miocárdico en comparación con BCP.
- ADO-R atenuó la adherencia de los neutrófilos al endotelio, mientras que ADO-CP no lo hizo.
Conclusiones:
- La administración de ADO durante la reperfusión es superior a la cardioplejía complementada con ADO para preservar la función regional postisquémica y atenuar la disfunción endotelial.
- Ambas estrategias reducen efectivamente el tamaño del infarto y el edema miocárdico.
- Los hallazgos destacan el momento crítico de la administración de ADO para maximizar los efectos cardioprotectores.
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