Objectives To evaluated the preventive effect of simvastatin combined with anisodamine on myocardial perfusion in no reflow, and to probe the possible mechanism.
Method Totally 16 minipig of 30–40 Kg were randomly divided into anisodamine groups (A, n=8) and anisodamine plus simvastatin group (A+S, n=8). Pigs in Group A+S were pretreated with oral simvastatin for 7 days, while pigs in A groups were given placebo. Seven days later, CAG was performed, and the dopper wire was used to record blood velocity. The pressure of aorta (Pa) was monitored. PMBS was injected to establish no reflow model. Anisodamine was injected into the LAD 2 min before PBMS was injected. The TIMI blood flow, TMPG and CTFC were recorded to evaluate the myocardial perfusion. The sample of myocardium in ischaemic zone and normal zone were measured. Blood sample was taken before and after the expeiment to measure the level of CK-MB, cTnI and hs-CRP. The percent of necrostic myocardium was calculated by myocardium stain method.
Results The TIMI blood flow and TFCs were better in Group A+S (p<0.05). The Pa was increased in both groups after PMBS injection at the early stage (p<0.01), and then it begun to decrease in Group A (p<0.05), while it remained its high level in Group A+S (p=0.042). The bAPV was increased in both groups, which was more obvious in the Group A after PMBS injection. After the injection of PMBS, the hAPV was sinificantly decreased in both groups (p<0.01), but it was still higher in group A+S (p=0.000). The CFR was continously deceased after the PMBS injection (p<0.05), but it was higher in Group A+S (p=0.025). The h-MR was further increased (p=0.024), with no difference between two groups after the PMBS injection. The level of serum cholesterol was similar between the two groups (p=0.063). CK-MB, TnI, hs-CRP and MDA were increased after the experiment, with the higher levels in Group A. NO was also increased (p=0.000), with the higher level in Group A+S (p=0.006). SOD was decreased (p=0.000) in both groups, with lower level in Group A (p=0.000). The infarcted size in group A was larger than that in A+S group (p<0.05).
Conclusion Simvastatin combined with anisodamine can significantly improve myocardial blood perfusion and porotect the myocardium against ischaemic injury during PCI. The possible mechanism involves improving of coronary haemodynamics, antiinflammation and antioxidation.
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