Nicorandil Attenuates Myocardial Dysfunction Associated with Transient Ischemia by Opening ATP-Dependent Potassium Channels

尼可地尔 格列本脲 医学 钾通道开放器 心肌顿抑 惊人的 缺血 麻醉 心脏病学 血流动力学 额定压力乘积 血流 内科学 血压 钾通道 心率 糖尿病 内分泌学
作者
John A. Auchampach,Icilio Cavero,Garrett J. Gross
出处
期刊:Journal of Cardiovascular Pharmacology [Ovid Technologies (Wolters Kluwer)]
卷期号:19 (5): 765-771 被引量:38
标识
DOI:10.1097/00005344-199205000-00012
摘要

The objective of this study was to determine whether ATP-dependent potassium channel activation is involved in the mechanism by which nicorandil reduces postischemic contractile dysfunction produced by a brief period of ischemia (myocardial stunning). Barbital-anesthetized dogs were subjected to 15-min left anterior descending (LAD) coronary artery occlusion followed by 3-h reperfusion. Saline or nicorandil (100 micrograms/kg + 25 micrograms/kg/min) were infused 15 min before and throughout occlusion with or without addition of the KATP channel antagonist, glibenclamide 0.3 mg/kg as an intravenous (i.v.) bolus. Regional myocardial blood flow was measured by radioactive microspheres, and left ventricular (LV) segment function was measured by sonomicrometry. There were no significant differences between the groups in area-at-risk size or collateral blood flow. In contrast, nicorandil significantly reduced mean aortic blood pressure (BP) and the rate-pressure product (RPP) which persisted throughout the occlusion period. In addition, nicorandil markedly accelerated recovery of segment shortening in the ischemic/reperfused region as compared with control dogs. Pretreatment of dogs with glibenclamide blocked none of the hemodynamic effects of nicorandil, but it did prevent improvement in reperfusion segment function. The small dose of glibenclamide used had no effect on hemodynamics or the degree of stunning. Thus, these results suggest that nicorandil attenuates stunning in anesthetized dogs by a direct cardioprotective effect as a result of KATP channel activation in ischemic myocardium.
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