Prophylactic captopril reduces perioperative myocardial ischemia in dogs  

作　　者：王士雯[1] 陈鸣和[1] 谭端军[1] 

机构地区：[1]中国人民解放军总医院老年心血管病研究所

出　　处：《中国介入心脏病学杂志》1998年第4期194-194,共1页Chinese Journal of Interventional Cardiology

摘　　要：Perioperative myocardial ischemia(PMI) is mainly caused by increasesin sympathetic nervous system activity due to stress,which results incoronary endothelial dysfunction,hence that it is hypothesized thatcaptopril may improve PMI.In our study,twenty mongrel dogs wererandomized for four groups;group Ⅰ:control,group Ⅱ:myocardialinfarction (MI) model,Group Ⅲ:MI+partial gastrectomy,group Ⅳ:MI+captopril+partial gastrectomy.Myocardial infarction wasproduced by ligation of left anterior descending coronary artery exceptthe group Ⅰ.In the group Ⅲ and Ⅳ,the hemodynamics,plasmaendothelin (ET) and nitric oxide (NO) on baseline,pre-andpostoperation were investigated two weeks after MI All animals werekilled by overdose anesthetic and their cardiac samples of non-infarction area taken for examining nitric oxide synthase (NOS)mRNA expression levels in vascular endothelial cells.Results:ingroup Ⅲ,the operation decreased the maximal rate of left ventricularpressure rise (LV+dP/dtmax),cardiac index (CI) and plasma No level,and increased left ventricular end diastolic pressure (LVEDP),time-course of isovolumic pressure fall (T constant),total peripheralresistance (TPR) and the levels of ET.In group Ⅳ,40 minutes afteradminstration of captopril,the TPR was decresed,and the t constantwas incresed significantly.The operation attenuated the TPR and Tconstant,but didn’t affect the other values.In situ hybridization it wasshowed that the expression levels of NOS mRNA was the highest ingroup Ⅰ,lower in groups Ⅱ and Ⅳ,and the lowest in group Ⅲ.Conclusions:1.Partial gastrectomy performed after myocardialinfarction may induce left ventricular systolic and diastolic dysfunction,and may produce coronary endothelial dysfunction;2.captopril canimprove left ventricular dysfuction and endothelial dysfunctioninduced by noncardiac operation.Perioperative myocardial ischemia(PMI) is mainly caused by increases in sympathetic nervous system activity due to stress,which results in coronary endothelial dysfunction,hence that it is hypothesized that captopril may improve PMI.In our study,twenty mongrel dogs were randomized for four groups;group Ⅰ:control,group Ⅱ:myocardial infarction (MI) model,Group Ⅲ:MI+partial gastrectomy,group Ⅳ: MI+captopril+partial gastrectomy.Myocardial infarction was produced by ligation of left anterior descending coronary artery except the group Ⅰ.In the group Ⅲ and Ⅳ,the hemodynamics,plasma endothelin (ET) and nitric oxide (NO) on baseline,pre-and postoperation were investigated two weeks after MI All animals were killed by overdose anesthetic and their cardiac samples of non- infarction area taken for examining nitric oxide synthase (NOS) mRNA expression levels in vascular endothelial cells.Results:in group Ⅲ,the operation decreased the maximal rate of left ventricular pressure rise (LV+dP/dtmax),cardiac index (CI) and plasma No level, and increased left ventricular end diastolic pressure (LVEDP),time- course of isovolumic pressure fall (T constant),total peripheral resistance (TPR) and the levels of ET.In group Ⅳ,40 minutes after adminstration of captopril,the TPR was decresed,and the t constant was incresed significantly.The operation attenuated the TPR and T constant,but didn't affect the other values.In situ hybridization it was showed that the expression levels of NOS mRNA was the highest in group Ⅰ,lower in groups Ⅱ and Ⅳ,and the lowest in group Ⅲ. Conclusions:1.Partial gastrectomy performed after myocardial infarction may induce left ventricular systolic and diastolic dysfunction, and may produce coronary endothelial dysfunction;2.captopril can improve left ventricular dysfuction and endothelial dysfunction induced by noncardiac operation.

关 键 词：gastrectomy DESCENDING SYMPATHETIC DIASTOLIC LVEDP minutes baseline systolic examining attenuated 

分 类 号：R542.2[医药卫生—心血管疾病]