Effect of intra-aortic balloon pumping and calcium antagonist for reducing coronary reperfusion injury.
Open heart surgery under aortic cross-clamping is often required, but coronary reperfusion injury after release of aortic cross-clamping is unavoidable irrespective of applications of various protective methods to the myocardium. The anterior descending branch of the left coronary artery of mongrel adult dogs was occluded for 2 hours and then reperfused. The protective effects of intra-aortic balloon pumping (IABP) and of a calcium antagonist "diltiazem hydrochloride" (diltiazem) on the decreased reperfusion of ischemic, border and normal areas were examined by measuring the regional myocardial blood flow (RMBF) using a radioactive microsphere method. Diltiazem could increase significantly the RMBF in the border area. IABP induced a significant increase in the RMBF of the same area more than Diltiazem, with the increase in the endocardial layer tending to be superior to that in the epicardial layer. The results suggested that diltiazem is very effective for reducing the coronary reperfusion injury. It is also suggested that IABP is even more effective than diltiazem because it increases the RMBF significantly and, moreover, has a tendency to increase the blood flow in the endocardial layer which is poor in collateral vessels and thus vulnerable to ischemia.
D000818:Animals; D001243:Assisted Circulation; D001552:Benzazepines / Q000627:therapeutic use*; D002118:Calcium / Q000037:antagonists & inhibitors*; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000503:physiopathology; D004110:Diltiazem / Q000627:therapeutic use*; D004285:Dogs; D007423:Intra-Aortic Balloon Pumping; D010477:Perfusion
D001552:Benzazepines; D004110:Diltiazem; D002118:Calcium