• 대한약리학회지
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• 제32권1호
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• pp.31-37
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• 1996

허혈전처치(IP)의 히혈-재관류손상에 대한 심근 보호작용의 기전을 규명하기 위한 일환으로 denosine에 의한 PKC자극이 허혈전처치의 주요 기전으로 작용할 가능성을 조사하였다. 흰쥐 적출심장의 Langendorff 관류 표본에서 실험적인 허혈(30분)-재관류(20분)손상을 유도하였고, 허혈전처치는 허혈-재관류 손상 유도 전에 5분 허혈-5분 재관류를 3회 반복하여 시행하였다. 심근 손상의 지표로 심수축기능, 세포질효소 유출을 측정하였다. Adenosine이 허혈전처치의 심보호 효과에 관여하는지를 관찰하기 위하여 adenosine수용체 억제제인 8-(p-sulfophenyl)-theophylline(SPT), Xanthine amine congener(XAC) 및 8-cyclopentyl-1,3-dipropylxanthine (DPCPX)을 허혈전처치 유도 전에 투여하였다. 또한 PKC가 허혈전처치의 세포내 매개인자로 관여 할 가능성을 관찰하기 위하여 PKC활성 억제제인 polymyxin B 및 chelerythrine과 PKC translocation 억제제인 colchicine을 허혈전처치 유도 전에 투여하였다. 연구성적은 다음과 같다. 1) 허혈전처치는 허혈재관류 심장의 심기능의 저하를 현저히 회복시켜 심기능 회복률은 75%에 달하였다. 2) 허혈-재관류 심장에서 lactate dehydrogenase유출증가는 허혈전처치에 의해 현저히 저하되었다. 3) Adenosine 비선택적 차단제인 SPT와 Al 선택적 차단제인 DPCPX 및 XAC의 투여가 허혈전처치에 의한 심기능회복 및 LDH 유출 감소에 영향을 미치지 않았다. 4) PKC활성 억제제인 polymyxin B 와 chelerythrine을 처치시 히혈전처치 심장의 심기능 회복률이 현저히 감소되었으며 LHD 유출 역시 대조군 심장의 수준으로 증가하였다. 5) PKC translocation을 방해하는 colchicine도 허혈전처치의 심보호 효과를 억제시켰다. 이상의 결과들로부터 adenosine은 흰쥐 심장에서 허혈전처치의 심보호효과에 중요한 세포외 매개물질로 작용할 가능성이 희박하며, PKC는 흰쥐 심장에서 허혈전처치시 세포내 매개 인자로 관여하여 허혈전처치에 의한 심보호효과에 중요한 역할을 할 수 있으리라 사료된다.

• Journal of Chest Surgery
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• 제25권4호
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• pp.347-355
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• 1992

The precise mechanism of the Excitation-Contraction Coupling is still uncertain. But the concept that Ca2+ induced Ca2+ release [CICR] from the Ryanodine receptor in the sarcoplasmic reticulum [foot structure] may play a major role in E-C coupling has been widely accepted since 1970`s. It is believed that increased cytosolic Ca2+ followed by CICR is main contributor for E-C coupling of striated muscle. Resulting phenomena of ischemic /post-reperfusion myocyte is increased cytosolic Ca2+, even to the absence of Ca2+ in reperfusate. So intracellular inhibitor to CICR might prevent the ischemic and reperfusion damage of myocardial cells. The relatively purified foot protein, especially heavy sarcoplasmic reticulum rich, of the skeletal muscle was incorporated into the black lipid bilayer [Phosphatidyl ethanolamine: Phosphatidyl serine=l: 1]. Under the steady state of membrane potential [+20 mV], ionic current through Ryanodine receptor was measured with Cs+ as charge carrier. In the cis chamber [Cytoplasmic side], Mg2+ strongly inhibited CICR of Ryanodine receptor[Kd=6.2 nM]. In conclusion, naturally existing intracellular free Mg2+ can inhibit CICR from intracellular Ca2+ reservior [heavy SR]. So post-ischemic or post-reperfusing myocardium could be preserved using additional free Mg2+ in cardioplegic solution or reperfusate, otherwise the optimal concentration is undetermined.

• Journal of Chest Surgery
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• 제27권7호
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• pp.563-570
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• 1994

Effect of ischemic preconditioning on left ventricular function after cardiac arrest in isolated rat heart.Ischemic preconditioning reduces infarct size caused by sustained ischemia. However, the effects of preconditioning on post ischemic cardiac function are not well-known. The objective of the present study was to determine whether preconditioning would improve the recovery of left ventricular functions after cardiac arrest in isolated rat heart model.Isolated rat hearts were allowed to equilibrate for 20 minutes and were then subjected to either 5 minutes of global, normothermic transient ischemia [Group 2 and 4] or not [Group 3]. A stabilization period of perfusion lasting 5 minutes after the termination of transient ischemia was followed by a standard global, normothermic 20 minute-ischemia and 35-minute reperfusion challenge [Group 3 and 4]. These following results were odtained.1. The recovery of left ventricular developed pressures showed no significant differences between Group 3 and Group 4 at 50 [P>0.3] and 85 minute [P>0.2].2. Heart rates showed no significant differences throughout all the course of experiment and between groups [P>0.5].3. The recovery of left ventricular maximum dP/dt showed no significant differences between Group 3 and Group 4 at 50 [P>0.1] and 85 minute [P>0.2].4. The recovery of pressure-rate products showed no significant differences between Group3 and Group 4 at 50 [P>0.5] and 85 minute [P>0.1].These results suggest that ischemic preconditioning does not provide significant benefit for the postischemic left ventricular functions in isolated rat hearts.

• Molecules and Cells
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• 제40권8호
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• pp.542-549
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• 2017

Cardiomyocyte apoptosis is initiated by various cellular insults and accumulated cardiomyocyte apoptosis leads to the pathogenesis of heart failure. Excessive reactive oxygen species (ROS) provoke apoptotic cascades. Manganese superoxide dismutase (MnSOD) is an important antioxidant enzyme that converts cellular ROS into harmless products. In this study, we demonstrate that MnSOD is down-regulated upon hydrogen peroxide treatment or ischemia/reperfusion (I/R) injury. Enhanced expression of MnSOD attenuates cardiomyocyte apoptosis and myocardial infarction induced by I/R injury. Further, we show that miR-23a directly regulates the expression of MnSOD. miR-23a regulates cardiomyocyte apoptosis by suppressing the expression of MnSOD. Our study reveals a novel model regulating cardiomyocyte apoptosis which is composed of miR-23a and MnSOD. Our study provides a new method to tackling apoptosis related cardiac diseases.

• The Korean Journal of Physiology and Pharmacology
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• 제28권3호
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• pp.209-217
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• 2024

In addition to cellular damage, ischemia-reperfusion (IR) injury induces substantial damage to the mitochondria and endoplasmic reticulum. In this study, we sought to determine whether impaired mitochondrial function owing to IR could be restored by transplanting mitochondria into the heart under ex vivo IR states. Additionally, we aimed to provide preliminary results to inform therapeutic options for ischemic heart disease (IHD). Healthy mitochondria isolated from autologous gluteus maximus muscle were transplanted into the hearts of Sprague-Dawley rats damaged by IR using the Langendorff system, and the heart rate and oxygen consumption capacity of the mitochondria were measured to confirm whether heart function was restored. In addition, relative expression levels were measured to identify the genes related to IR injury. Mitochondrial oxygen consumption capacity was found to be lower in the IR group than in the group that underwent mitochondrial transplantation after IR injury (p < 0.05), and the control group showed a tendency toward increased oxygen consumption capacity compared with the IR group. Among the genes related to fatty acid metabolism, Cpt1b (p < 0.05) and Fads1 (p < 0.01) showed significant expression in the following order: IR group, IR + transplantation group, and control group. These results suggest that mitochondrial transplantation protects the heart from IR damage and may be feasible as a therapeutic option for IHD.

• Journal of Chest Surgery
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• 제24권5호
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• pp.429-437
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• 1991

Beta hydroxytrimethylammonium butyrate[L-carnitine] is highly concentrated in myocardium and it is essential substance for transfer of fatty acids into the mitochondria. We respect that L-carnitine has protective action to myocardium during ischemia. I studied coronary flow and CK - MB isoenzyme of coronary effluent of Langendorff`s isolated rat heart model. As a control group 5 Sprague-Dowley species rat hearts were connected to Langendorff`s isolated rat heart model and perfused for 30 minutes with Kreb-Henseleit buffer solution. After cessation of perfusion for 30 minutes they were reperfused for 30 minutes. In experimental group 10 Sprague-Dowley species rat hearts were perfused with 10mmole /L of L-carnitine contained in Kleb-Henseleit buffer solution. In equilibrium state, coronary flow was 1.7 times greater in experimental group. During reperfusion, both group showed equally decreased flow amount of about 60% of that of equilibrium state. CK-MB isoenzyme level of perfused coronary fluid showed no significant difference in equilibrium state. In reperfusion. CK-MB isoenzyme levels of control group were 17.61$\pm$8. 68U/L at 25 minutes, 23.32$\pm$4.15U /L at 30 minutes; and in experimental group, 13.63$\pm$6. 08U/L at 15 minutes and 13.6$\pm$8.41U /L at 30 minutes respectively. Those values in both states showed significantly lower CK-MB level in experimental group. In conclusion, L-carnitine prevent ischemic myocardial damage during ischemic and reperfusion state of Langendorff`s isolated rat hearts and also I suggest the L-carnitine act potent coronary vasodilator during preischemic and postischemic states of rat hearts.

• The Korean Journal of Physiology and Pharmacology
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• 제17권4호
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• pp.283-289
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• 2013

This study was designed to evaluate the protective effect of Korean red ginseng (KRG) against ischemia/reperfusion (I/R) injury in isolated guinea pig heart. KRG has been shown to possess various ginsenosides, which are the major components of Panax ginseng. These components are known naturally occurring compounds with beneficial effects and free radical scavenging activity. The heart was induced to ischemia for 60 min, followed by 120 min reperfusion. The hearts were randomly allocated into five groups (n=8 for each group): normal control (N/C), KRG control, I/R control, 250 mg/kg KRG group and 500 mg/kg KRG group. KRG significantly increased hemodynamics parameters such as aortic flow, coronary flow and cardiac output. Moreover, KRG significantly increased left ventricular systolic pressure (LVSP), the maximal rate of contraction (+dP/$dt_{max}$) and maximal rate of relaxation (-dP/$dt_{max}$). Also, treatment of KRG ameliorated electrocardiographic index such as the QRS, QT and RR intervals. Moreover, KRG significantly suppressed the lactate dehydrogenase, creatine kinase-MB fraction and cardiac troponin I and ameliorated the oxidative stress markers such as malondialdehyde and glutathione. KRG was standardized through ultra performance liquid chromatograph analysis for its major ginsenosides. Taken together, KRG has been shown to prevent cardiac injury by normalizing the biochemical and oxidative stress.

• 대한핵의학회지
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• 제39권2호
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• pp.87-93
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• 2005

Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary Intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCI. In the management of patients with 57 segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but mote complete. Recently published evidences in the pharmacologic therapy including antiplatelet and stalin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

• Journal of Chest Surgery
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• 제47권3호
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• pp.233-239
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• 2014

Background: As hypertrophied myocardium predisposes the patient to decreased tolerance to ischemia and increased reperfusion injury, myocardial protection is of utmost importance in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS). Methods: Consecutive 314 patients (mean age, $62.5{\pm}10.8$ years; 143 females) with severe AS undergoing isolated AVR were included. Postoperative myocardial injury (PMI) was defined as 1) maximum postoperative creatinine kinase isoenzyme MB or troponin-I levels ${\geq}10$ times of reference, 2) postoperative low cardiac output syndrome or episodes of ventricular arrhythmia, or 3) left ventricular ejection fraction of less than 55% and decrease in left ventricle (LV) ejection fraction of more than 20% of the baseline value. Results: There were 90 patients (28.7%) who developed PMI. There were five cases of early death (1.6%), all of whom had PMI. On multivariable analysis, the use of histidine-tryptophan-ketoglutarate (HTK) solution instead of blood cardioplegia (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.63 to 5.77; p=0.001), greater LV mass (OR, 1.04; 95% CI, 1.01 to 1.07; p=0.007), and increased cardiac ischemic time (OR, 1.13; 95% CI, 1.05 to 1.22; p<0.001) were independent predictors for PMI. Patients who had PMI showed significantly inferior long-term survival than those without PMI (p=0.049). Conclusion: PMI occurred in a considerable proportion of patients undergoing AVR for severe AS and was associated with poor long-term survival. HTK cardioplegia, higher LV mass, and longer cardiac ischemic duration were suggested as predictors of myocardial injury.

• Journal of Chest Surgery
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• 제31권2호
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• pp.95-101
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• 1998

짧은 기간의 허혈은 뒤에 오는 장시간의 허혈 및 재관류시에 심근의 손상방지에 효과가 있는 것으로 보고되고 있으나 그 기전에 대해서는 논란이 많다. 본 연구에서는 심근에 단기간의 허혈조건을 부여한 후 심근보호액을 이용하여 심정지를 유도하였고 다시 재관류하였을 때 심근 기능의 회복에 미치는 영향을 연구하기 위해 적출 쥐 심장모델을 이용하여 2 시간의 저장기를 이용하여 재관류시의 기능을 비교하였다. 10 마리의 실험군에서는 심근보호액을 이용한 심정지전에 1 분간의 전체 허혈기를 가지고 5 분간의 재관류를 3 번 반복하는 방법으로 허혈조건부여를 하였으며 대조군에서는 위와 같은 조건부여 없이 2 시간의 심근보호액을 이용한 심정지 및 저장기를 가졌다. 2 시간의 저장기를 $0^{\circ}C$의 심근보호액에서 가진 후 재관류를 하여 두 군간의 회복시의 기능을 비교하였다. 재관류 20 분후의 회복기 기능의 비교에서 허혈 조건부여를 한 실험군에서 대조군에 비하여 좌심실 발생압 및 좌 심실압 순간 변화율에서 우수한 회복율을 보였다. 심정지전의 수치를 100으로 본 경우의 재관류시의 좌심실 발생압의 회복율에서 허혈 조건부여를 준 실험군에서는 93.20$\pm$15.7%의 회복율을 보인 반면 대조군에서는 67.3$\pm$15.6%의 회복율을 보여 차이가 있었다. 좌심실압 순간 변화율의 회복율에서 대조군은 54.7$\pm$18.2%의 회복율을 보인 반면 실험군에서는 78.1$\pm$15.1% 의 회복율을 보였다. 심박동수 및 관동맥 관류량에서는 양 군에서 통계적으로 유의한 차이를 발견하지 못하였으며 같은 압력으로 관류한 심근보호액의 관류량에서도 유의한 차이를 보이지 않았다. 이상의 결과 허혈 조건부여는 적출 쥐 심장에서 심근보호액을 이용한 심정지 및 2 시간의 저장 후 재관류시의 심근 기능 회복에 재관류시 심근기능 회복에 도움이 된다고 생각되며 이는 심근보호액의 관류량 및 관류저항과는 다른 기전에 의한 것으로 생각된다.