Why the study?
Does norepinephrine mediate delayed cardioprotection against stunning and alter postischemic arrhythmias in a rabbit model?
Does norepinephrine mediate delayed cardioprotection against stunning and alter postischemic arrhythmias in a rabbit model?
Absolute Event Rate: 71.7% vs 51.2%
p-value: p=< 0.05
Norepinephrine provides delayed preconditioning against myocardial stunning via α1-adrenoceptors, but at the cost of increased postischemic ventricular arrhythmias.
Caution against clinical use in ischemia-reperfusion; leaves open norepinephrine-mediated delayed cardioprotection in humans.
Objective α 1 -adrenoceptor activation confers myocardial protection from ischemic injury. We tested whether norepinephrine mediates delayed cardioprotection against stunning and whether this alters postischemic arrhythmias. Methods New Zealand White rabbits were assigned to three groups: Control-group ( n = 7): no drugs. Norepinephrine-group ( n = 7): 75 μg norepinephrine/kg bodyweight (bw). Norepinephrine/prazosin-group ( n = 7):75 μg norepinephrine and 15 μg prazosin/kg bw. After 24 h, hearts were excised, perfused with buffer and subjected to 20 min of ischemia followed by 120 min of reperfusion. Results (a) Developed pressures (dP) ( P syst – P diast ) at the end of reperfusion: C: 51.2 ± 5.0%, NE: 71.7 ± 5.1% ( p < 0.05 vs. C), NEP: 50.7 ± 5.0%. (b) Ventricular extra beats (vebs) were detected throughout the experiments. C: 0.41 ± 0.15 vebs/min, NE: 1.06 ± 0.18 vebs/min ( p < 0.05 vs. C), NEP: 1.17 ± 0.3 vebs/min. Conclusion Norepinephrine confers delayed preconditioning against myocardial stunning via an α 1 -adrenoceptor mediated pathway. Norepinephrine-mediated preconditioning involves a beneficial effect towards stunning, but at the expense of a higher rate of postischemic ventricular arrhythmia.
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Marktanner et al. (2003) studied Myocardial stunning (n=21). Norepinephrine vs. No drugs (Control) was evaluated on Developed pressures (dP) at the end of reperfusion (p=< 0.05).
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