Salih ERDEM, Ersöz GONCA, Günselin BAŞOĞLU, Elifnur AYDEMİR

İskemi Sonrası Verilen Kannabidiol Reperfüzyon ile Uyarılan Aritmilere Karşı Koruyucu Etkilidir

Amaç: Kannabidiol (KBD) psikolojik etkileri bulunmayan bir bitkisel kannabinoiddir. Klinik uygulamada Huntington hastalığı ve ultipl skleroz tedavisinde kullanılmaktadır. Sıçanlarda koroner arter ligasyonu öncesi verilen KBD’nin reperfüzyon ile uyarılan ventriküler aritmilere karşı koruyucu etkili olduğu bildirilmiştir. Ancak reperfüzyon aritmilerinin klinik tedavisinde kullanılabilmesi için miyokardiyal iskemi sonrasında verildiğinde de etkili olduğu gösterilmelidir. Bu çalışmanın amacı sıçanlarda miyokardiyal iskemi ve reperfüzyon periyotları boyunca infüzyon yolu ile uygulanan KBD tedavisinin reperfüzyon aritmilerine olan etkilerini araştırmaktır. Gereç ve Yöntemler: Miyokardiyal iskemi ve reperfüzyon, anestezi uygulanmış erkek sıçanlarda sırasıyla sol ana koroner arterin 6 dakika ligasyonu ve damar üzerindeki ligatürün 6 dakika açılmasıyla reperfüzyon gerçekleştirildi. Çalışma üç ayrı deney grubunda yürütüldü; (1) Kontrol (n= 6), (2) Lig-KBD (n=6), (3) Rep-KBD (n=6). KBD infüzyon ile sırasıyla Lig-KBD grubunda ligasyon ve Rep-KBD grubunda reperfüzyon periyodu boyunca 9 μg/90 μL/dk/kg dozda intravenöz yolla verildi. Bulgular: Ligasyon boyunca KBD tedavisi ventriküler prematüre kasılma (VPK) süresini kontrol grubuna göre anlamlı azalttı (p=0,024). Reperfüzyonda KBD tedavisi, aritmi skoru, ventriküler taşikardi (VT), ventriküler prematüre kasılma (VPK) ve toplam aritmi sürelerini kontrol grubuna göre azalttı (Toplam aritmi süresi: kontrol; 38,19(6,29-72,44) sn, Lig-KBD; 8,69(0-34,9) sn, Rep-KBD; 1,49(0,14-4,87)sn, p=0,007). Sonuç: Bu çalışmanın sonuçları reperfüzyon periyodu boyunca verilen KBD’nin reperfüzyon ile uyarılan aritmilere karşı güçlü antiaritmik etkiye sahip olduğunu göstermektedir. KBD reperfüzyon aritmilerinin klinik tedavisinde kullanılabilme potansiyeline sahiptir.

Cannabidiol Given Following the Ischemia Confers Protection Against Reperfusion-Induced Arrhythmia

Aim: Cannabidiol (CBD) is a non-psychoactive plant cannabinoid. In clinical practice, it has been used in the treatment of Huntington’s disease and multiple sclerosis. CBD given before the coronary ligation has been reported to be protective against reperfusion-induced arrhythmia in rats. However, it should also be demonstrated that is effective against ventricular arrhythmias during ischemia and reperfusion in order to be adapted to the clinical treatment of reperfusion arrhythmias. The aim of this study is to investigate the effects of CBD applied by infusion during both ischemia and reperfusion periods on reperfusion arrhythmias in rats. Material and Methods: Myocardial ischemia and reperfusion were accomplished by the ligation of the left main coronary artery for 6 min and release of the tie on the vessel for 6 min in male anesthetized grurats, respectively. CBD was administered by infusion pump at a dose of 9 μg/90 μL/min/kg during the ligation in Lig-CBD group in Rep-CBD group reperfusion, respectively. Experimental groups of the study were: (1) Control (n = 6), (2) Lig-CBD (n = 6), and (3) Rep-CBD (n = 6). Results: CBD treatment during the ligation significantly decreased the duration of ventricular premature contraction (VPC) compared to the control group (p=0.024). CBD that was given during the reperfusion period significantly decreased the ventricular premature contraction (VPC), ventricular tachycardia (VT) and total length of arrhythmias compared to the control group (total length of arrhythmias: control: 38.19(6.29-72.44) sec, Lig-CBD; 8.69(0-34.9) sec, Rep-CBD; 1.49(0.14-4.87) sec, p=0.007). Conclusion: The results of the study indicate that CBD given during the reperfusion period has a strong antiarrhythmic effect on reperfusioninduced arrhythmia. These results strengthen the potential use of CBD in the clinical treatment of reperfusion arrhythmias.

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