title: Differences in infarct size with lidocaine as compared with bretylium tosylate in acute myocardial ischemia and reperfusion in pigs.
abstract: The effects of the antiarrhythmic drugs lidocaine and bretylium tosylate on myocardial necrosis were studied in anesthetized pigs subjected to 60-min coronary occlusion followed by 3-h reperfusion. Group A (n = 7) received lidocaine (average dose +/- SD = 1,828 +/- 515 mg) before and during coronary occlusion and after reperfusion; the other series (group B, n = 7) received bretylium tosylate (3,457 +/- 1,323 mg). Infarct size was 16.3 +/- 14.7% in the lidocaine group as compared with 68.6 +/- 12.6% (p less than 0.01) in the bretylium group. In vitro release of superoxide anion from porcine granulocytes was studied using the lucigenin-dependent chemiluminescence technique. Lidocaine significantly reduced the peak chemiluminescence response to zymosan from 3.34 +/- 0.44 without lidocaine to 2.23 +/- 0.46 (p less than 0.01) and 1.06 +/- 0.17 mV (p less than 0.001), with lidocaine concentrations of 20 and 200 micrograms/ml, respectively. Bretylium had no effect on the chemiluminescence response. Adherence of porcine granulocytes to plastic was also reduced from 332 +/- 32 cells/mm2 (no lidocaine) to 247 +/- 35 and 206 +/- 26 cells/mm2 with lidocaine concentrations of 20 and 200 micrograms/ml, respectively (p less than 0.001). Bretylium had no significant effect. Eight additional bretylium-treated pigs received either rabbit antiporcine granulocyte serum (group C, n = 4) to reduce circulating granulocytes or nonimmune serum (group D, n = 4). Infract size in the granulocyte-depleted pigs was 26.6 +/- 5.6% as compared with 51.4 +/- 5.5% in pigs that received nonimmune serum (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: N
authors.initials: N
authors.lastname: Hatori
authors.forename: R L
authors.initials: RL
authors.lastname: Roberts
authors.forename: H
authors.initials: H
authors.lastname: Tadokoro
authors.forename: L
authors.initials: L
authors.lastname: Ryden
authors.forename: K
authors.initials: K
authors.lastname: Satomura
authors.forename: M C
authors.initials: MC
authors.lastname: Fishbein
authors.forename: E R
authors.initials: ER
authors.lastname: Stiehm
authors.forename: E
authors.initials: E
authors.lastname: Corday
authors.forename: J K
authors.initials: JK
authors.lastname: Drury
mesh_terms: D000818:Animals; D001157:Arterial Occlusive Diseases / Q000503:physiopathology; D001950:Bretylium Tosylate / Q000493:pharmacokinetics / Q000494:pharmacology*; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006098:Granulocytes / Q000276:immunology / Q000378:metabolism; D066298:In Vitro Techniques; D007957:Leukocyte Adherence Inhibition Test; D008012:Lidocaine / Q000493:pharmacokinetics / Q000494:pharmacology*; D008163:Luminescent Measurements; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D015428:Myocardial Reperfusion Injury / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D009336:Necrosis / Q000473:pathology; D010101:Oxygen Consumption / Q000187:drug effects; D013481:Superoxides / Q000378:metabolism; D013552:Swine
chemical_list: D013481:Superoxides; D001950:Bretylium Tosylate; D008012:Lidocaine