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European Heart Journal 1991 12(3):442-450;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Beneficial effects of coronary venous retroinfusion but not left atrial administration of superoxide dismutase on myocardial necrosis in pigs

N. HATORI, H. TADOKORO, K. SATOMURA, A. MIYAZAKI, M. C. FISHBEIN, L. RYDÉN*,, E. CORDAY and J. K. DRURY

Division of Cardiology, Department of Medicine, and Department of Pathology, Cedars-Sinai Medical Center, and the University of California Los Angeles, School of Medicine Los Angeles, California, U.S.A

Received 18 March 1990; revised 15 June 1990; .

Correspondence:Lars ryden .M.D,Department of Cardiology,Karolnska Hosipital,S-10401 Stockholm,Sweden.

Abstract

The efficacy of coronary venous versus left atrial administration of superoxide dismutase was studied in 24 open chest pigs which had 60 min of left anterior descending coronary artery occlusion followed by 3 h reperfusion. The pigs were randomly assigned to three treatment protocols: group A (n=8) superoxide dismutase (5mg kg–1) was infused into the great cardiac vein for 30min beginning 15 min before reperfusion; group B (n=8) superoxide dismutase (5 mg kg–1) was infused into the left atrium in a similar manner to group A; group C (n=8) bovine serum albumin (5 mg kg–1) was infused into the great cardiac vein in the same manner as group A. Infarct size, expressed as percent of area at risk, was significantly smaller in group A (28.2±13.0%) than groups B (58.7 ±8.3%) and C (61.6±7.2%) (P<0.05). The results indicate that retroinfusion of superoxide dismutase into the great cardiac vein before reperfusion may be an effective treatment for the prevention of reperfusion injury, even in the absence of a well developed coronary collateral circulation. Antegrade (left atrial) administration of the same amount of superoxide dismutase did not decrease infarct size in pigs. The most likely explanation for this difference in efficacy is that drug delivery with left atrial administration is dependent on antegrade flow with reperfusion which is less reliable and less efficient than coronary venous retroinfusion. The latter provides a predictably high concentration of superoxide dismutase to the jeopardized myocardium during the period ofischaemia before reperfusion.

Key Words: Coronary vein • superoxide dismutase • swine heart • myocardial infarction


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