Reversible myocardial damage in gerbil brain ischaemia and its prevention by beta-adrenergic blockade.

A Kolin, A Brezina, J A Kellen, A J Lewis, J W Norris
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Abstract

Acute cerebral infarction in gerbils, produced by unilateral carotid ligation, was used as a model to investigate secondary myocardial changes. The extent of the myocardial damage revealed by succinic dehydrogenase (SDH) histochemistry and by release of myocardial creatine phosphokinase (MB-CK) was measured in gerbils sacrificed from 3 to 48 h after either carotid ligation, carotid isolation only or skin incision only. For technical reasons dead animals were excluded from analysis. Of surviving ligated animals 74% developed neurological deficits related to brain ischaemia. A significant weight increase in the ipsilateral hemisphere was found at 6-10 h, and maximal histological damage at 16 h, both partially reversible thereafter. Non-ligated animals did not develop neurological changes, and showed neither brain swelling nor cerebral histopathology. Extensive cardiac damage was shown by the SDH method from 3 h postoperatively, and confirmed by the elevated serum levels of MB-CK in the carotid-ligated group. The SDH changes were identical with those described in the hearts of patients with acute intracranial lesions, and appeared to be reversible. The effect of beta-adrenergic blockade was assessed in this model. Metoprolol tartrate injected intraperitoneally 3 h before and 1 h after carotid ligation (10 mg/kg each dose) significantly decreased the extent of myocardial damage as estimated both with SDH histochemistry and MB-CK serum levels. It had no effect on the ischaemic brain changes. These results strongly support the concept of catecholamine mediation of myocardial injury resulting from acute brain lesions.

沙鼠脑缺血的可逆性心肌损伤及其β -肾上腺素能阻断的预防。
以沙鼠单侧颈动脉结扎引起的急性脑梗死为模型,研究其继发性心肌改变。采用琥珀酸脱氢酶(SDH)组织化学和心肌肌酸磷酸激酶(MB-CK)释放法测定沙鼠在颈动脉结扎、颈动脉隔离和皮肤切开后3 ~ 48 h处死的心肌损伤程度。由于技术原因,死亡动物被排除在分析之外。存活的结扎动物中,74%出现与脑缺血相关的神经功能缺损。6-10 h时同侧半球体重显著增加,16 h时组织学损伤最大,此后两者部分可逆。未结扎的动物没有出现神经系统的变化,也没有出现脑肿胀和脑组织病理学。术后3h的SDH法显示广泛的心脏损伤,颈动脉结扎组血清MB-CK水平升高证实了这一点。SDH变化与急性颅内病变患者的心脏相同,并且似乎是可逆的。在该模型中评估β -肾上腺素能阻断的效果。颈动脉结扎前3小时和结扎后1小时腹腔注射酒石酸美托洛尔(每次剂量10 mg/kg),通过SDH组织化学和MB-CK血清水平均可显著降低心肌损伤程度。它对缺血性脑变化没有影响。这些结果有力地支持儿茶酚胺介导急性脑损伤引起的心肌损伤的概念。
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