Ischemia/Reperfusion-induced Myocardial Damage: Role of Carbon Dioxide

缺血/再灌注引起的心肌损伤：二氧化碳的作用

• 批准号: 23592023
• 负责人: YAMAMOTO Hiroshi
• 金额: $ 3.49万
• 依托单位: Akita University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2013
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23592023/
• 关键词: 心筋虚血再灌流; 二酸化炭素; ナトリウム/水素交換; ナトリウム/カルシウム交換; 心筋保護; 開心術; 心筋虚血; 虚血再灌流; 塩素イオン; 重炭酸イオン; 心筋虚血再灌流傷害; 好気的代謝; 二酸化炭素産生; イオン移動; CO2産生

We investigated the acid-base characteristic alterations of blood cardioplegia (BCP) during aortic cross-clamping in hearts arrested with BCP and during in vitro simulated ischemia. In 40 patients undergoing cardiac surgery following an aortic cross clamp, hearts were infused with a hypothermic BCP intermittently and lastly with a normothermic BCP prior to aortic cross clamp release. We measured pH, pCO2, [HCO3-], and [Cl-] of the coronary sinus effluent in the final BCP. BCP was assessed under in-vitro gassing at with 95% N2 + 5% CO2 (n = 6), 50% N2 + 50% CO2 (n = 3), or 100% CO2 (n = 6). The coronary sinus effluent, compared with the pre-infused BCP, exhibited significantly lower pH and greater pCO2 with no change in the [HCO3-] level. In vitro, the 100% CO2 gassing groups exhibited a significant increase in [HCO3-] under high pCO2-induced acidification. Under anoxia and CO2 retention during aortic cross-clamping, BCP can be a bicarbonate donor to the myocardium.

我们研究了用BCP和体外模拟缺血期间的心脏中主动脉交叉联系期间血液心骨（BCP）的酸碱特征改变。在40例主动脉交叉夹后接受心脏手术的患者中，心脏间歇性BCP间歇性BCP在主动脉交叉释放之前间歇性地且最后在常规的BCP中注入。我们在最终BCP中测量了冠状窦出水的pH，PCO2，[HCO3-]和[Cl-]。在95％n2 + 5％CO2（n = 6），50％N2 + 50％CO2（n = 3）或100％CO2（n = 6）的情况下，对BCP进行了体外隔气评估。与预先注入的BCP相比，冠状动脉鼻窦流出物显示出明显降低的pH和更大的PCO2，而[HCO3-]水平没有变化。在体外，在高PCO2诱导的酸化下，100％的二氧化碳基团在[HCO3-]上表现出显着增加。在主动脉跨钳位期间的缺氧和二氧化碳保留下，BCP可以是心肌的碳酸氢盐供体。