Copyright © 1993 by the European Society of Cardiology.
© 1993 The Europen Society of Cardiology
Coronary venous retroinfusion of felodipine reducing infarct size without affecting regional myocardial blood flow
Department of Cardiology, Karolinska Hospital Stockholm, Sweden
*Astra-Hässle Research Laboratories Mölndal, Sweden
Received 17 February 1993; revised 26 May 1993; .
Correspondence: Professor Lars Ryden, Department of Cardiology, Karolinska Hospital, 104 01 Stockholm, Sweden.
Abstract
Effects on the ischaemic and reperfused myocardium of felodipine, a vasoselective calcium blocker, retrogradely infused into the coronary vein was investigated in a porcine model.
Sixteen open-chest pigs underwent 45 min of myocardial ischaemia by occlusion of the left anterior descending coronary artery followed by 4h of reperfusion. Either felodipine (felo-retro group, 7 nmol.kg–1: n = 6) or the corresponding amount of vehicle (vehicle group: n = 5) was retroinfused over 30 min starting 5 min prior to reperfusion. In a third group, the same amount of felodipine was administered intravenously (felo-iv group n = 5). Myocardial regional blood flow was measured with radioactive microspheres prior to ischaemia and at different times of reperfusion.
Infarction size, expressed as a percentage of the area at risk, was significantly reduced to 62±12% in the felo-retro group as compared to 86±12% (P<0.05) and 94±5% (P<0.05) in the vehicle and felo-iv group, respectively. Following an early hyperaemia, the regional blood flow decreased uniformly in the reperfused myocardium in all three groups and there were no significant differences between the groups at any period of reperfusion.
In conclusion, felodipine retroinfused into the coronary vein could salvage ischaemic and reperfused myocardium without affecting the regional blood flow. The mechanism of this protective effect should be explained by factors other than an increased myocardial blood flow during reperfusion.
Key Words: Felodipine • calcium antagonists • myocardial injury • ischaemia • reperfusion
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