Marcin Kunecki, Tomasz Oleksy, Jan Martynów, Michalina Zygmunt, Marek Deja, Tomasz Kargul, Jolanta Biernat, Piotr Podolec, Krzysztof S Gołba, Wojciech Płazak
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引用次数: 0
Abstract
Background: Previous studies on animal models have suggested that δ-opioid receptor (OR) signaling is the primary pathway responsible for opioids' cardioprotective effect. We hypothesize that the μ-OR's activation protects the human heart muscle.
Methods: We performed the experiments on muscular trabeculae obtained from the right atrial appendages of 104 consecutive patients subjected to coronary artery bypass surgery. Two trabeculae from each patient were studied simultaneously and exposed to 60 min of hypoxia with subsequent 60 min of reoxygenation. Remifentanil (5 μM or 50 μM) or sufentanil (40 μM or 400 μM) was used from the time of reoxygenation. Trabeculae contractility was assessed as the maximal amplitude of the contraction at baseline, after 60 min of hypoxia, during reoxygenation, and after norepinephrine application.
Results: During reperfusion, the application of remifentanil improved cardiomyocytes' function as compared to the control group (time from reperfusion: 15 min: 39.8% vs. 21.7%, p = 0.01; 30 min: 41.4% vs. 21.8%, p = 0.01; 60 min: 42.7% vs. 26.9%, p = 0.04; after norepinephrine: 64.7% vs. 43.2%, p = 0.03). The application of sufentanil did not influence cardiomyocyte function as can be seen when comparing the results of the experimental and control group.
Conclusions: Remifentanil, but not sufentanil, induces a cardioprotective effect on human right atria muscle in in vitro conditions, manifested as the increased amplitude of their contraction during reperfusion after 60 min of ischemia.
背景:动物模型研究表明,δ-阿片受体(OR)信号通路是阿片保护心脏的主要途径。我们假设μ-OR的激活可以保护人类的心肌。方法:对连续104例冠状动脉搭桥术患者右心耳肌小梁进行实验研究。同时研究每位患者的两根小梁,暴露于缺氧60分钟,随后再充氧60分钟。从复氧开始使用瑞芬太尼(5 μM或50 μM)或舒芬太尼(40 μM或400 μM)。小梁收缩性以基线、缺氧60分钟后、复氧期间和应用去甲肾上腺素后的最大收缩幅度来评估。结果:再灌注时,与对照组相比,瑞芬太尼可改善心肌细胞功能(再灌注时间:15 min: 39.8% vs. 21.7%, p = 0.01;30 min: 41.4% vs. 21.8%, p = 0.01;60 min: 42.7% vs. 26.9%, p = 0.04;去甲肾上腺素组:64.7%比43.2%,p = 0.03)。舒芬太尼的应用不影响心肌细胞的功能,从实验和对照组的结果可以看出。结论:在体外条件下,瑞芬太尼而非舒芬太尼对人右心房肌具有心脏保护作用,表现为缺血60 min后心肌再灌注收缩幅度增大。
期刊介绍:
BMC Pharmacology and Toxicology is an open access, peer-reviewed journal that considers articles on all aspects of chemically defined therapeutic and toxic agents. The journal welcomes submissions from all fields of experimental and clinical pharmacology including clinical trials and toxicology.