Circulation, Vol 88, 1845-1851, Copyright © 1993 by American Heart Association
I Kubota, M Yamaki, T Shibata, E Ikeno, Y Hosoya and H Tomoike
BACKGROUND. ATP-sensitive K+ channels are activated when the myocardium
becomes ischemic. However, the role of the ATP-sensitive K+ current in the
emergence of ECG ST changes during ischemia remained unclarified. METHODS
AND RESULTS. The left anterior descending coronary artery (LAD) was
cannulated and perfused with arterial blood from the carotid artery through
a bypass tube in 8 anesthetized, open-chest dogs. An array of 60 unipolar
electrodes mounted on a sock was used to record epicardial electrograms of
the whole heart. Pinacidil (10 micrograms.kg-1 x min- 1), an ATP-sensitive
K+ channel opener, was infused into the bypass tube for 2 minutes, and the
electrograms were recorded before and after the infusion. The elevation of
the ST segment and the increase of QRST area were observed spatially over
the LAD-perfused region. At the electrode showing the largest ST segment
elevation, the activation recovery interval, an index of action potential
duration, was shortened from 202 +/- 9 to 111 +/- 18 milliseconds (P <
.001). These electrographic changes were similar to those noted in 2-minute
coronary occlusion (n = 8). The extent of ST segment elevation during
coronary occlusion was attenuated after the intravenous pretreatment with
glibenclamide (0.3 mg/kg), a blocker of the KATP channel (n = 5).
CONCLUSIONS. The findings of this study suggest that the activation of
ATP-sensitive K+ channels during a bout of acute myocardial ischemia plays
an important role in the emergence of ECG ST elevation.
ARTICLES
Role of ATP-sensitive K+ channel on ECG ST segment elevation during a bout of myocardial ischemia. A study on epicardial mapping in dogs
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
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