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심근의 허혈시 아데노신을 함유한 심정지액의 심근보호 효과
The Protective Effect of Adenosine Included Cardioplegits in Myocardial Ischemia

유경종    (연세대학교 심장혈관센터, 심혈관연구소, 심장혈과외과   ); 강면식    (연세대학교 심장혈관센터, 심혈관연구소, 심장혈과외과  );
  • 초록

    Although the effects of adenosine on the heart, including the clinical suppression of cardiac arrhythmias, have been recognized for more than half a century, it is only in the last decade that the therapeutic potential of adenosine has been recognized. The objective of this study was to determine if augmentation of myocardial adenosine levels during global ischemia improves functional recovery after reperfusion. We used to modified Langendonf system to evaluate myocardial protective effect. Isolated rat hearts were subjected to 90 minutes of deep hypothermic arrest(15 $^{\circ}C$ ) with modified St. Thomas'Hospital cardioplegic solution used to provide myocardial protection. Myocardial adenosine levels were augmented during ischemia by providing exogenous adenosine in the cardioplegic solution. Two groups of hearts w re studied: (1) control group(n=10) cardioplegia alone; (2) adenosine group(n=10) adenosine(0.75mg/kg/min) added to the cardioplegic solution. Significantly better percent recovery(p $\pm$ 3.6% vs 66.6 $\pm$ 5.9%, airtic overflow volume : 61.7 $\pm$ 11.6% vs 37.2 $\pm$ 15.4%, coronary flow volume 77.1 $\pm$ 7.5% vs 57.2 $\pm$ 11.1%, and cardiac output : 65.6 $\pm$ 11.5% vs 44.2 $\pm$ 12.4%). Heart rate was similar in two groups(94.4 $\pm$ 4.8% vs 95.3 $\pm$ 6.8%). Adenosine groups resulted in significantly rapid recovery time of heart beat after reperEusion(p $\pm$ 7.6 sec. vs 179.0 $\pm$ 131.1sec.). In biochemical study, CPK levels(0.1 $\pm$ 0.3U/L vs 1.4 $\pm$ 0.8U/L) and lactic acid levels(0.08 $\pm$ 0.Immol/L vs 0.34 $\pm$ 0.2 mmol/L) were significantly low in adenosine groups(p


  • 주제어

    아데노신 .   심근보호 .   재관류 손상.  

  • 참고문헌 (21)

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    17. Acadesine improves surgical myocardial protection with blood cardioplegia in ischemically injured canine hearts , Vinten-Johansen J;Nakanishi K;Zhao ZQ(et al.) , Circulation / v.88,pp.350-358,
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    19. 심마비용액의 삼투압이 심근보호에 미치는 영향 -연세의대 심마비용액과 성토마스병원 심마비용액의 비교연구- , 강면식;유경종;조범구 , 대흉외지 / v.22,pp.927-935,
         
    20. Adenosine and its cardiovascular effect , Freilich A;Tepper D , Am Heart J / v.123,pp.1324-1328,
    21. Effects of acadesine on perioperative cardiac morbidity in a placebo-controlled, double blind study , Leung J;Stanley T;Mathew J(et al.) , J Am Coll Cardiol / v.19,pp.112a,
  • 이 논문을 인용한 문헌 (1)

    1. 1998. "The Comparison of Protective Effects of Adenosine Included Cardioplegia According to Adenosine Dosage" 大韓胸部外科學會誌 = The Korean journal of thoracic and cardiovascular surgery, 31(9): 837~844     

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