Korean Circulation Journal

  • 제44권6호
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  • Pages.423-428
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  • 2014
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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The Effect of Radiographic Contrast Media on Reperfusion Injury in the Isolated Rat Heart

  • Lee, Soo Yong (Department of Internal Medicine, Pusan National University Yangsan Hospital) ;
  • Jang, Young Ho (Institute of Cancer Rehabilitation and Convalescence, Yoonsung Hospital) ;
  • Lee, Mi Young (Department of Preventive Medicine, Keimyung University School of Medicine) ;
  • Hwang, Jongmin (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Lee, Sang Hyun (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Chon, Min Ku (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Hwang, Sun Ae (Cardiovascular Research Laboratory, Pusan National University Yangsan Hospital) ;
  • Kim, Jeong Su (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Park, Yong Hyun (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Chun, Kook Jin (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Kim, June Hong (Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine)
  • 투고 : 2014.06.30
  • 심사 : 2014.09.10
  • 발행 : 2014.11.30
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: We investigated the effects of commonly used contrast media (CM) on myocardial ischemia-reperfusion injury in isolated rat hearts. Subjects and Methods: Isolated rat hearts were subjected to 30 minutes of regional ischemia and 2 hours of reperfusion. The following CM (1 mL/1 L Krebs-Henseleit buffer) were randomly perfused for 15 minutes beginning 5 minutes before reperfusion and ending 10 minutes after reperfusion: iohexol (n=8), iopromide (n=8), ioversol (n=8), iomeprol (n=8), iopamidol (n=7), ioxaglate (n=8), and iodixanol (n=7). The effects of a direct bolus injection of undiluted iohexol, iopromide, or ioxaglate (each n=6) via the aortic root immediately prior to reperfusion were also evaluated. The area of necrosis, expressed as the percentage of the area at risk (AN/AR), and cardiodynamic variables were measured. Results: The AN/AR of the control and experimental groups in the order described in methods was $33.7{\pm}6.4%$, $30.3{\pm}7.4%$, $34.7{\pm}12.6%$, $29.2{\pm}10.2%$, $20.9{\pm}7.6%$, $22.6{\pm}8.7%$, $18.8{\pm}7.9%$, and $19.9{\pm}11.4%$, respectively. Groups that received iomeprol and ioxaglate exhibited significantly decreased AN/AR values compared to those of control hearts (p=0.042 and p=0.013). No significant differences in the AN/AR were observed between control hearts and the groups injected with a single bolus of CM. No significant hemodynamic changes were noted after reperfusion among the groups. Conclusion: The overall effects of the CM on coronary reperfusion were not deleterious, and better effects were noted in two CM groups. However, it is unclear whether this result was attributed to a specific physiochemical property of the CM.

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참고문헌

  1. Heinrich MC, Kuhlmann MK, Grgic A, Heckmann M, Kramann B, Uder M. Cytotoxic effects of ionic high-osmolar, nonionic monomeric, and nonionic iso-osmolar dimeric iodinated contrast media on renal tubular cells in vitro. Radiology 2005;235:843-9. https://doi.org/10.1148/radiol.2353040726
  2. Aspelin P, Aubry P, Fransson SG, et al. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 2003;348:491-9. https://doi.org/10.1056/NEJMoa021833
  3. Romano G, Briguori C, Quintavalle C, et al. Contrast agents and renal cell apoptosis. Eur Heart J 2008;29:2569-76. https://doi.org/10.1093/eurheartj/ehn197
  4. Wessely R, Koppara T, Bradaric C, et al. Choice of contrast medium in patients with impaired renal function undergoing percutaneous coronary intervention. Circ Cardiovasc Interv 2009;2:430-7. https://doi.org/10.1161/CIRCINTERVENTIONS.109.874933
  5. Oriyanhan W, Yamazaki K, Miwa S, Takaba K, Ikeda T, Komeda M. Taurine prevents myocardial ischemia/reperfusion-induced oxidative stress and apoptosis in prolonged hypothermic rat heart preservation. Heart Vessels 2005;20:278-85. https://doi.org/10.1007/s00380-005-0841-9
  6. Gonzalez-Castillo C, Rubio R, Zenteno-Savin T. Coronary flow-induced inotropism is modulated by binding of dextrans to the endothelial luminal surface. Am J Physiol Heart Circ Physiol 2003;284:H1348-57. https://doi.org/10.1152/ajpheart.00323.2002
  7. Seeliger E, Sendeski M, Rihal CS, Persson PB. Contrast-induced kidney injury: mechanisms, risk factors, and prevention. Eur Heart J 2012;33: 2007-15. https://doi.org/10.1093/eurheartj/ehr494
  8. Sendeski MM. Pathophysiology of renal tissue damage by iodinated contrast media. Clin Exp Pharmacol Physiol 2011;38:292-9. https://doi.org/10.1111/j.1440-1681.2011.05503.x
  9. Seeliger E, Becker K, Ladwig M, Wronski T, Persson PB, Flemming B. Up to 50-fold increase in urine viscosity with iso-osmolar contrast media in the rat. Radiology 2010;256:406-14. https://doi.org/10.1148/radiol.10091485
  10. Falck G, Bruvold M, Schjott J, Jynge P. Protective effects of repetitive injections of radiographic contrast media on the subsequent tolerance to ischemia in the isolated rat heart. Cardiovasc Intervent Radiol 2000; 23:466-71. https://doi.org/10.1007/s002700010106
  11. Piper HM, Garcia-Dorado D. Prime causes of rapid cardiomyocyte death during reperfusion. Ann Thorac Surg 1999;68:1913-9. https://doi.org/10.1016/S0003-4975(99)01025-5
  12. Falck G, Schjott J, Jynge P. Hyperosmotic pretreatment reduces infarct size in the rat heart. Physiol Res 1999;48:331-40.
  13. Pastukh V, Ricci C, Solodushko V, Mozaffari M, Schaffer SW. Contribution of the PI 3-kinase/Akt survival pathway toward osmotic preconditioning. Mol Cell Biochem 2005;269:59-67. https://doi.org/10.1007/s11010-005-2536-z
  14. Cecchi E, Liotta AA, Gori AM, et al. Relationship between blood viscosity and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Int J Cardiol 2009;134:189-94. https://doi.org/10.1016/j.ijcard.2008.01.039
  15. Wasilewski J, Turczyn' ski B, Slowin' ska L, Kowalik V, Osadnik T, Polon' ski L. Haemorheological factors and myocardial reperfusion in patients with ST-elevation myocardial infarction undergoing primary coronary intervention. Kardiol Pol 2007;65:778-85; discussion 786-7.
  16. Yalcin O, Ulker P, Yavuzer U, Meiselman HJ, Baskurt OK. Nitric oxide generation by endothelial cells exposed to shear stress in glass tubes perfused with red blood cell suspensions: role of aggregation. Am J Physiol Heart Circ Physiol 2008;294:H2098-105. https://doi.org/10.1152/ajpheart.00015.2008
  17. Schmid I, Didier D, Pfammatter T, et al. Effects of non-ionic iodinated contrast media on patient heart rate and pressures during intra-cardiac or intra-arterial injection. Int J Cardiol 2007;118:389-96. https://doi.org/10.1016/j.ijcard.2006.12.011
  18. Schmiedel E. Evaluation of the adverse effects of iomeprol. Eur J Radiol 1994;18 Suppl 1:S104-8. https://doi.org/10.1016/0720-048X(94)90103-1
  19. Reed M, Meier P, Tamhane UU, Welch KB, Moscucci M, Gurm HS. The relative renal safety of iodixanol compared with low-osmolar contrast media: a meta-analysis of randomized controlled trials. JACC Cardiovasc Interv 2009;2:645-54. https://doi.org/10.1016/j.jcin.2009.05.002
  20. Heinrich MC, Haberle L, Muller V, Bautz W, Uder M. Nephrotoxicity of iso-osmolar iodixanol compared with nonionic low-osmolar contrast media: meta-analysis of randomized controlled trials. Radiology 2009; 250:68-86. https://doi.org/10.1148/radiol.2501080833
  21. From AM, Al Badarin FJ, McDonald FS, Bartholmai BJ, Cha SS, Rihal CS. Iodixanol versus low-osmolar contrast media for prevention of contrast induced nephropathy: meta-analysis of randomized, controlled trials. Circ Cardiovasc Interv 2010;3:351-8. https://doi.org/10.1161/CIRCINTERVENTIONS.109.917070