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Effect of adenosine therapy at reperfusion on myocardial infarct size in dogs.
Cardiovasc Res. 1996 May; 31(5):711-8.CR

Abstract

OBJECTIVES

The concept of lethal reperfusion injury in ischemic myocardium has been the subject of controversy. Adenosine administered during reperfusion has been reported to limit lethal reperfusion injury in several studies. On the contrary, it has been reported that cardioprotection may not be achieved with adenosine alone but may occur if adenosine is co-administered with lidocaine. Still other investigators have reported no beneficial effect of adenosine, given with or without lidocaine. If the positive reports are reproducible, they are important both because they provide evidence for the existence of reperfusion injury and establish a rationale for preventing it. Thus, the present study was done to determine if adenosine could limit lethal reperfusion injury in a canine model of regional myocardial ischemia and reperfusion, carefully controlled for baseline predictors of infarct size.

METHODS

Dogs (n = 37) of either sex were subjected to 90 min of coronary occlusion followed by 3 h of reperfusion. Two groups of dogs received adenosine (150 micrograms/kg/min) intravenously for 155 min starting 5 min prior to the reperfusion. One treated group received adenosine only and a second group received adenosine plus lidocaine (2 mg/kg). Control dogs received a saline infusion. After 3 h of reflow, hearts were excised and infarct size was measured and expressed as a percentage of the ischemic area at risk (AAR). To control for variation in infarct size due to variation in collateral blood flow (CBF), infarct size among groups was compared using ANCOVA, using CBF as the independent variable and infarct size as the dependent variable.

RESULTS

Transmural collateral blood flow and AAR were not significantly different between any of the groups. Mean infarct size (adjusted by ANCOVA) in control dogs (n = 9) was 38.1 +/- 5.3% of the AAR. Neither adenosine (n = 9) nor adenosine plus lidocaine (n = 7) significantly limited infarct size (35.6 +/- 5.6% AAR and 38.1 +/- 7.7% AAR, respectively; both P = NS).

CONCLUSIONS

Intravenous adenosine therapy (150 micrograms/kg/min) during reperfusion, whether administered alone or in dogs previously treated with lidocaine, did not limit infarct size after 90 min of regional ischemia in canine myocardium.

Authors+Show Affiliations

Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8763400

Citation

Vander Heide, R S., and K A. Reimer. "Effect of Adenosine Therapy at Reperfusion On Myocardial Infarct Size in Dogs." Cardiovascular Research, vol. 31, no. 5, 1996, pp. 711-8.
Vander Heide RS, Reimer KA. Effect of adenosine therapy at reperfusion on myocardial infarct size in dogs. Cardiovasc Res. 1996;31(5):711-8.
Vander Heide, R. S., & Reimer, K. A. (1996). Effect of adenosine therapy at reperfusion on myocardial infarct size in dogs. Cardiovascular Research, 31(5), 711-8.
Vander Heide RS, Reimer KA. Effect of Adenosine Therapy at Reperfusion On Myocardial Infarct Size in Dogs. Cardiovasc Res. 1996;31(5):711-8. PubMed PMID: 8763400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of adenosine therapy at reperfusion on myocardial infarct size in dogs. AU - Vander Heide,R S, AU - Reimer,K A, PY - 1996/5/1/pubmed PY - 1996/5/1/medline PY - 1996/5/1/entrez SP - 711 EP - 8 JF - Cardiovascular research JO - Cardiovasc Res VL - 31 IS - 5 N2 - OBJECTIVES: The concept of lethal reperfusion injury in ischemic myocardium has been the subject of controversy. Adenosine administered during reperfusion has been reported to limit lethal reperfusion injury in several studies. On the contrary, it has been reported that cardioprotection may not be achieved with adenosine alone but may occur if adenosine is co-administered with lidocaine. Still other investigators have reported no beneficial effect of adenosine, given with or without lidocaine. If the positive reports are reproducible, they are important both because they provide evidence for the existence of reperfusion injury and establish a rationale for preventing it. Thus, the present study was done to determine if adenosine could limit lethal reperfusion injury in a canine model of regional myocardial ischemia and reperfusion, carefully controlled for baseline predictors of infarct size. METHODS: Dogs (n = 37) of either sex were subjected to 90 min of coronary occlusion followed by 3 h of reperfusion. Two groups of dogs received adenosine (150 micrograms/kg/min) intravenously for 155 min starting 5 min prior to the reperfusion. One treated group received adenosine only and a second group received adenosine plus lidocaine (2 mg/kg). Control dogs received a saline infusion. After 3 h of reflow, hearts were excised and infarct size was measured and expressed as a percentage of the ischemic area at risk (AAR). To control for variation in infarct size due to variation in collateral blood flow (CBF), infarct size among groups was compared using ANCOVA, using CBF as the independent variable and infarct size as the dependent variable. RESULTS: Transmural collateral blood flow and AAR were not significantly different between any of the groups. Mean infarct size (adjusted by ANCOVA) in control dogs (n = 9) was 38.1 +/- 5.3% of the AAR. Neither adenosine (n = 9) nor adenosine plus lidocaine (n = 7) significantly limited infarct size (35.6 +/- 5.6% AAR and 38.1 +/- 7.7% AAR, respectively; both P = NS). CONCLUSIONS: Intravenous adenosine therapy (150 micrograms/kg/min) during reperfusion, whether administered alone or in dogs previously treated with lidocaine, did not limit infarct size after 90 min of regional ischemia in canine myocardium. SN - 0008-6363 UR - https://www.unboundmedicine.com/medline/citation/8763400/Effect_of_adenosine_therapy_at_reperfusion_on_myocardial_infarct_size_in_dogs_ L2 - https://academic.oup.com/cardiovascres/article-lookup/doi/10.1016/0008-6363(95)00235-9 DB - PRIME DP - Unbound Medicine ER -