Seckin TUNCER, Ahmet AKKOCA, Murat Cenk CELEN, Nizamettin DALKİLİC

Papillary Muscle Action Potential Alterations After Abdominal Ischemia-Reperfusion

Abdominal aortic aneurysm (AAA) has a high prevalence and surgical treatment is still the best option for many reasons. Surgical treatment needs abdominal blood flow to be discontinued, which leads to secondary complications caused by ischemiareperfusion (I/R) in different organs. Since distant organ damages are seen after surgery, abdominal ischemia reperfusion results in post-treatment deaths especially due to heart based problems. In this study, we aimed to investigate the possible alterations in action potential parameters of papillary muscle after abdominal I/R injury. Adult Wistar-Albino rats were divided into two groups randomly: SHAM group (only laparotomy was performed) and I/R group (abdominal aorta was clamped for 1 hour and reperfused for 2 hours). After the operational period, left ventricle papillary muscles were isolated and action potential (AP) recording experiments were carried out in-vitro. Significant hyperpolarization was seen in resting membrane potential in I/R group. There was no alteration in the general shape of the action potential after I/R. Some delayed-after-depolarizations were recorded, that suggests an impaired persistent Na+ channel activity when interpreted with resting membrane potential findings.This study shows that I/R does not affect the AP parameters except for resting membrane potential. However, it is also likely that the sodium-calcium exchanger (NCX) causes delayed arrhythmias after depolarization due to dysfunction of unknown causes.

Abdominal I skemi-Reperfu zyon Sonrası Papiller Kas Aksiyon Potansiyelinde Meydana Gelen Değişiklikler

Abdominal aort anevrizması (AAA) yüksek prevalansa sahiptir ve cerrahi tedavi hala birçok nedenden ötürü en iyi seçenek olarak görülmektedir. Cerrahi tedavi abdominal kan akımının bir süreliğine kesilmesine neden olmakta ve iskemi-reperfüzyon (I/R) olarak adlandırılan bu durum farklı organlarda hasar meydana getirerek sekonder komplikasyonlara yol açmaktadır. Post-operatif komplikasyonlar arasında kardiyak olanlar en yüksek morbiditeye sahiptir. Bu çalışmada, abdominal I/R sonrası kalp yeterliliği bakımından en önemli role sahip papiller kasa ait aksiyon potansiyelinde meydana gelebilecek değişikliklerin araştırılması amaçlanmıştır. Yetişkin Wistar-Albino sıçanlardan abdominal aortu 1 saat süreyle klemplenip ve 2 saat süreyle reperfüzyon gerçekleştirilenler I/R, yalnızca laparotomi yapılanlar ise SHAM grubu olarak adlandırılmıştır. Reperfüzyon periyodunun hemen ardından sol ventrikül papiller kasları izole edilmiş ve aksiyon potansiyeli kayıtları yapılmıştır. Dinlenim zar potansiyelinin I/R grubunda anlamlı ölçüde hiperpolarize olduğu görülürken, aksiyon potansiyelinin genel görünümünde ise herhangi bir değişiklik meydana gelmemiştir. Kayıtlarda görülen gecikmiş-depolarizasyonlar, dinlenim zar potansiyeli bulguları ile yorumlandığında, Na+ kanal aktivitesindeki kalıcı bir değişimi düşündürmektedir. Sonuç olarak, bu çalışma I/R ile papiller kas hücre zarında hiperpolarizasyon meydana geldiğini fakat aksiyon potansiyeli parametrelerinde anlamlı bir değişikliğin olmadığını göstermiştir. Gözlenen gecikmiş aritmilerin sodyum-kalsiyum değiş-tokuşcusunun (NCX) disfonksiyonu sebebiyle ortaya çıkmış olabileceğini düşündürmektedir.

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