EVALUATION OF THE EFFECTIVENESS OF 5'-NUCLEOTIDASE INHIBITOR AND ALLOPURINOL IN MYOCARDIAL ISCHEMIA

Abstract

The effect of 5'-nucleotidase inhibitor (AMP-C) and xanthine oxidase inhibitor (Allopurinol: ALLO) on myocardial functional recovery and the restoration of myocardial high energy phosphates after 15 min of normothermic global ischemic insult, was studied in the isolated isovolemic Langendorff rat heart model. Fifty nine rats were divided into 4 groups: Group I; saline. Group II; AMP-C plus ALLO, Group III; AMP-C, Group IV; ALLO. Intermittent infusion of drugs was delivered in 3 ml of solution at 5 min intervals during ischemia. Percent recovery of left ventricular systolic function was as follows: Group I; 74.2±3.6%, Group II; 87.7±1.7%. Group III; 83.5±3.1%, Group IV; 86.4±2.6%. Improved recovery was statistically significant only in Group II (p<0.05 vs Group I). Suppression of reactive hyperemia was seen with re-perfusion in the groups which had been treated with AMP-C (i.e., Groups II and III). Myocardial adenine nucleotides and purines were measured in 6 hearts in each group using high performance liquid chromatography. Myocardial ATP levels was 0.89±0. 16 nmol/mg left ventricular wet weight in Group I, 1.370.12 in Group 11 (p<0.05 vs Group I), 1.42±0.17 in Group 111 (p<0.05) and 1.17±0.15 in Group IV. This study demonstrates that intermittent infusion of AMP-C plus ALLO during global myocardial ischemia results in improved myocardial functional recovery and improved preservation of high energy phosphates.