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Titolo:
REDUCTION IN REPERFUSION-INDUCED MYOCARDIAL NECROSIS IN DOGS BY RHEOTHRX INJECTION (POLOXAMER-188-NF), A HEMORHEOLOGICAL AGENT THAT ALTERS NEUTROPHIL FUNCTION
Autore:
SCHAER GL; HURSEY TL; ABRAHAMS SL; BUDDEMEIER K; ENNIS B; RODRIGUEZ ER; HUBBELL JP; MOY J; PARRILLO JE;
Indirizzi:
RUSH PRESBYTERIAN ST LUKES MED CTR,RUSH MED COLL,CARDIOL SECT,1653 W CONGRESS PKWY CHICAGO IL 60612 RUSH PRESBYTERIAN ST LUKES MED CTR,RUSH MED COLL,CLIN IMMUNOL SECT CHICAGO IL 60612 BURROUGHS WELLCOME CO,DIV PHARMACOL RES TRIANGLE PK NC 27709 BURROUGHS WELLCOME CO,DIV PHARMACOKINET & DRUG METAB RES TRIANGLE PK NC 27709
Titolo Testata:
Circulation
fascicolo: 6, volume: 90, anno: 1994,
pagine: 2964 - 2975
SICI:
0009-7322(1994)90:6<2964:RIRMNI>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
IRREVERSIBLE ISCHEMIC-INJURY; CORONARY-ARTERY OCCLUSION; NO-REFLOW PHENOMENON; INFARCT SIZE; VENTRICULAR-FUNCTION; BLOOD-VISCOSITY; CANINE MODEL; ACTIVATION; FLUOSOL; ANGIOPLASTY;
Keywords:
INFARCTION; REPERFUSION; NEUTROPHILS; POLOXAMER 188;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
53
Recensione:
Indirizzi per estratti:
Citazione:
G.L. Schaer et al., "REDUCTION IN REPERFUSION-INDUCED MYOCARDIAL NECROSIS IN DOGS BY RHEOTHRX INJECTION (POLOXAMER-188-NF), A HEMORHEOLOGICAL AGENT THAT ALTERS NEUTROPHIL FUNCTION", Circulation, 90(6), 1994, pp. 2964-2975

Abstract

Background Reperfusion after prolonged coronary artery occlusion may be followed by additional myocardial necrosis persisting for hours to days. Potential mechanisms include neutrophil-mediated injury and compromised flow within the microcirculation of the reperfused myocardium. Poloxamer 188 is a nonionic surfactant with beneficial hemorheological and neutrophil-inhibitory properties. The purpose of the present study was to determine if poloxamer 188 is capable of reducing the myocardial injury associated with sustained reperfusion and to examine the effect of treatment duration. Methods and Results Three groups of closed-chest dogs underwent 90 minutes of left anterior descending coronaryartery occlusion (angioplasty balloon) and 72 hours of reperfusion. Poloxamer 188, formulated as RheothRx Injection (Burroughs Wellcome Co), was given as a 75 mg/kg IV bolus 15 minutes before reperfusion followed by a 150 mg.kg(-1).h(-1) continuous TV infusion for 4 hours (n=13)or 48 hours (n=13); control dogs (n=12) received saline for 48 hours. The 48-hour infusion of poloxamer 188 resulted in a 42% reduction in infarct size (as a percent of the area at risk) compared with the control group (25.0+/-4.2% versus 43.3+/-4.3%, P<.01), whereas the 4-hour group demonstrated a 25% reduction in infarct size compared with the control group (32.4+/-4.3%, P=.08). ANCOVA demonstrated that the 48-hour infusion of poloxamer 188 reduced myocardial infarct size independent of differences in collateral blood flow (P=.002 versus control). A trend toward infarct size reduction was observed in the 4-hour infusiongroup (P=.098 versus control by ANCOVA). Plasma creatine phosphokinase concentration was lower in both poloxamer 188-treated groups (P<.05 versus control). Global left ventricular ejection fraction at 72 hoursof reperfusion was improved in the 48-hour infusion group compared with the control group (43+/-3.1% versus 33+/-2.0%, P<.05), whereas ejection fraction in the 4-hour group was 37+/-1.3% (P=NS versus control). Regional ventricular function was also significantly better in the 48-hour infusion group compared with the control group. In vitro studiesdemonstrated that at concentrations comparable to those achieved in vivo, poloxamer 188 inhibited neutrophil chemotaxis. This finding may represent a beneficial mechanism of action. Conclusions A 48-hour infusion of poloxamer 188 reduced myocardial infarct size and improved leftventricular function in this dog model of 90 minutes of coronary artery occlusion and 72 hours of reperfusion. The finding that the 4-hour infusion of poloxamer 188 did not result in similar benefits suggests that additional reperfusion injury occurred between 4 and 48 hours.

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Documento generato il 04/12/20 alle ore 03:41:33