Ali İhsan PARLAR, Ufuk TÜTÜN, Kamuran PAMUK, Ayşen AKSOYEK, A. Tolga ULUS, Zülfikar Kadir SARITAŞ, Salih Fehmi KATIRCIOĞLU, Eser ÖZGENCİL, Nusret APAYDIN

Effect of ATP- $MgCl_2$ on myocardial ischemia-reperfusion injury: An in vivo experimental study

Bu çalışmada iskemi-reperfüzyon hasarında ATP- $MgCl_2$ kullanımının myokard üzerine etikisi hemodinamik ve metabolik parametreler yardımı ile araştırıldı. Oniki adet sokak köpeği, ATP- $MgCl_2$ ve kontrol olmak üzere 2 eşit gruba rastgele olarak ayrılarak çalışmada kullanıldı. Bu işlemi izleyerek hayvanlara sağ torakotomi yapıldı ve perikard açıldı. Sol anterior desendens arteri 15 dakika süre ile ligature edilerek iskemik bırakıldı ve daha sonra ligatür açılarak reperfüzyon yapıldı. Daha sonra kardiyopulmoner bypasa girildi. Aortaya kros-klemp konulmasını takiben, aorta asendense konulan bir kanül yardımı ile soğuk kristaloid kardioplejik verilerek kardiak arrest sağlandı. Çalışma grubuna perfüzyon başlangıcından itibaren ATP- $MgCl_2$ (70+70 mmol/1) 0,25 ml/kg/saat hızında verildi, kontrol grubunda hiçbir sağaltım yapılmadı. Hemodinamik ve metabolik ölçümler bazal, 60 dakika, 120. dakika ve 180. dakikalarda alındı. Çalışmamızda; kardiak output değerleri çalışma grubunda anlamlı olarak yüksekti. Çalışma ve kontrol grubunda 3. saatte 2370 ± 31 ml/dk ve 900 ± 45 ml/dk (P < 0,05) idi. MOE (miyokardial oksijen ekstraksiyonu) ve MLE (miyokardial laktat ekstraksiyonu) kontrol grubunda anlamlı olarak yüksekti. MOE perfüzyonun 3. saati sonunda çalışma grubunda 50 ± 2 ml, kontrol grubunda 55 ± 3 mi ve MLE ise çalışma grubunda - 0,06 ± 0,02 mmol/ml, kontrol grubunda - 0,12 ± 0,07 mmol/ml idi (P < 0,05). Bu çalışma sonucunda; ATP-MgCl2 kullanımı iskemi-reperfüzyon yaralanmalarında hemodinamik ve metabolik parametreleri düzeltmesi açısından faydalı bulunmuştur.

ATP- $MgCl_2$ kullanımının myokard hasarına etkisi; In vivo deneysel çalışma

We investigated the effect of ATP- $MgCl_2$ on myocardial hemodynamics and metabolism. The study included 12 mongrel dogs that were randomly divided into 2 groups: the control and the ATP- $MgCl_2$ (study) groups. Following a right thoracotomy, the left anterior descending artery was ligated for 15 min and then reperfusion was performed. After the ischemic period, cardiopulmonary bypass was initiated and the aorta was cross-clamped. ATP- $MgCl_2$(70+70 mmol/1) 0.25 ml/kg per h was given to the study group at the start of the ischemic period. Hemodynamic and metabolic measurements were obtained at basal, and then after 60, 120, and 180 min of reperfusion Cardiac output values were significantly higher in the study group; at the end of the third hour of reperfusion they were 2370 ± 31 ml/min in the study group and 900 ± 45 ml/min in the control group (P < 0.05). Myocardial Oxygen Extraction (MOE) and Myocardial Lactate Extraction (MLE) values were significantly higher in the control group; at the end of the third hour of the reperfusion MOE values were 50 ± 2 ml in the study group and 55 ± 3 ml in the control group, while MLE values were -0.06 ± 0.02 mmol/ml in the study group and -0.12 ± 0.07 mmol/ml in the control group (P < 0.05). Hemodynamic and metabolic parameters revealed that the use of ATP-MgCl2 might be beneficial in reducing ischemia-reperfusion damage.

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