Successful Ventricular Defibrillation by the Selective Sodium-Hydrogen Exchanger Isoform-1 Inhibitor Cariporide
| Autor: | Julieta D Kolarova, Elizabeth Hoffner, Iyad M. Ayoub, Raúl J. Gazmuri |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Sodium-Hydrogen Exchangers
Defibrillation Heart Ventricles medicine.medical_treatment Electric Countershock Diastole Ischemia Blood Pressure In Vitro Techniques Guanidines chemistry.chemical_compound Physiology (medical) medicine Animals Lactic Acid Sulfones Cardiopulmonary resuscitation Fibrillation Cariporide business.industry medicine.disease Ventricular Premature Complexes Cardiopulmonary Resuscitation Rats Survival Rate Disease Models Animal chemistry Anesthesia Ventricular Fibrillation Ventricular fibrillation Regression Analysis medicine.symptom Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Perfusion |
| Zdroj: | Circulation. 104:234-239 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.104.2.234 |
| Popis: | Background — Sodium-hydrogen exchanger isoform-1 (NHE-1) activation worsens functional myocardial abnormalities associated with ischemia and reperfusion. We hypothesize that these abnormalities may limit cardiac resuscitation from ventricular fibrillation (VF) and investigated whether NHE-1 inhibition with the benzoylguanidine derivative cariporide could improve resuscitability, postresuscitation myocardial function, and short-term survival in isolated heart and intact rat models of VF. Methods and Results — In the isolated rat heart, VF was induced for 25 minutes. Perfusion was interrupted for the initial 10 minutes and restarted at 10% of baseline flow for the remaining 15 minutes (simulating chest compression). Cariporide ameliorated ischemic contracture, prevented postresuscitation diastolic dysfunction, and favored earlier return of contractile function. In the intact rat, cariporide, injected into the right atrium before chest compression was started (after 6 minutes of untreated VF), prompted spontaneous defibrillation between minutes 7 and 9 of chest compression in 6 of 8 rats. In contrast, electrical defibrillation was required in each of 8 control rats after completion of a predetermined 16-minute interval of VF. After resuscitation, cariporide-treated rats had less ventricular ectopic activity and normalized their hemodynamic function faster. Electrical defibrillation was then timed in control rats to match the time when spontaneous defibrillation occurred in cariporide-treated rats. With comparable VF duration, postresuscitation hemodynamic dysfunction was ameliorated by cariporide, but only when more severe ischemia was modeled by prolongation of the interval of untreated VF from 6 to 10 minutes. Conclusion — NHE-1 inhibition may represent a novel and remarkably effective intervention for resuscitation from VF. |
| Databáze: | OpenAIRE |
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