Circulation, Vol 78, 450-461, Copyright © 1988 by American Heart Association
NE Farber, GM Pieper and GJ Gross
Modification of the thromboxane: prostacyclin ratio alters the severity of
reperfusion arrhythmias and postischemic damage in long-term, irreversibly
injured myocardium. In this study, the effects of the thromboxane
synthetase inhibitor dazmegrel and the thromboxane receptor antagonist BM
13.505 on myocardial postischemic functional recovery and preservation of
tissue adenine nucleotides was examined after a 15- minute episode of
ischemia followed by 3 hours of reperfusion (myocardial stunning).
Dazmegrel (3 or 8 mg/kg) or BM 13.505 (10 mg/kg) was given 15 minutes
before coronary occlusion and compared with a control group in
barbital-anesthetized dogs. Regional segment shortening (percent segment
shortening, sonomicrometry), regional myocardial blood flow (microspheres),
and coronary venous eicosanoid and high-energy phosphate levels (biopsies
after 3 hours of reperfusion) were measured. Areas at risk, regional
myocardial blood flow, and regional segment shortening during coronary
occlusion were similar in all groups. Dazmegrel (3 mg/kg) attenuated the
decrease in endocardial and midmyocardial adenosine 5'-triphosphate, and
both doses significantly improved regional segment shortening during
reperfusion. Coronary venous thromboxane levels were significantly
decreased throughout the experiment in both dazmegrel-treated groups, and
thromboxane levels were significantly elevated in the control group 3 hours
after reperfusion. Prostacyclin, measured in the form of its main
metabolite, 6-keto-prostaglandin F1 alpha, did not change significantly in
the control group throughout the experiment, but it was markedly increased
in dazmegrel groups throughout reperfusion, particularly in the dazmegrel
group receiving 3 mg/kg. BM 13.505 exerted no beneficial effects on
postischemic function or metabolism. In conclusion, after a reversible
ischemic insult, postischemic recovery of function and metabolic status was
not enhanced by preocclusion treatment with a thromboxane receptor blocker,
and thus, the beneficial effects of thromboxane synthesis inhibition on
postischemic abnormalities was not due to a reduction in thromboxane but
was the result of endoperoxide shunting and a subsequent increase in
prostacyclin. Therefore, thromboxane does not appear to be an important
mediator of reversible ischemia-reperfusion damage.
ARTICLES
Lack of involvement of thromboxane A2 in postischemic recovery of stunned canine myocardium
Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee 53226.
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