Norepinephrine-induced delayed cardioprotection against stunning is at the expense of a higher postischemic arrhythmia rate.

Department of Thoracic and Cardiovascular Surgery, Heinrich-Heine-University Düsseldorf, Germany. marktann@uni-duesseldorf.de

OBJECTIVE: alpha(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 microg norepinephrine/kg bodyweight (bw). Norepinephrine/prazosin-group (n=7):75 microg norepinephrine and 15 microg 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 alpha(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.

PMID: 14627970 [PubMed - indexed for MEDLINE]