Summary
The effect of hyaluronidase (HY) on myocardial infarct size after experimental coronary artery occlusion was studied in two groups of dogs.
Group I received HY as a bolus of 500 IU/kg BW prior to occlusion of a medium-sized marginal or diagonal vessel during 90 minutes. Another 500 IU/kg of HY was infused at constant rate during coronary occlusion. Another artery of the same heart was occluded under comparable conditions without therapy. This artery was reperfused before the first dose of HY.
In group II the LAD was occluded in a closed chest preparation after intracoronary injection of 500 IU/kg BW of HY. During the ensuing 24 hours occlusion period the dose of 200 IU/kg HY was repeated seven times in regularly spaced intervals. Neither collateral nor normal flow was altered in both groups by HY and hemodynamic conditions remained constant. Nevertheless in group I therapy led to a reduction of infarct size from 29% (control) to 14% necrosis of the perfusion area after HY, whereas after 24 hours of continuing therapy the size of the infarcted area did not differ from control.
Thus HY was able to significantly postpone the transition of ischemia to necrosis but was unable to prevent it. Infarct size following 24 hours of occlusion was not different from a control group.
Zusammenfassung
Die Beeinflussung der myokardialen Infarktgröße durch Hyaluronidase (HY) nach experimentellem Koronargefäßverschluß wurde an zwei Gruppen von Hunden untersucht.
Gruppe I erhielt HY als Bolus von 500 IU/kg KG vor 90minütiger Okklusion eines mittelgroßen Marginal- oder Diagonalastes. Die gleiche Dosis HY wurde mit konstanter Geschwindigkeit während des Koronarverschlusses infundiert. Ein zweites Gefäß desselben Herzens wurde bei vergleichbaren Bedingungen ohne Therapie verschlossen. Diese Arterie wurde vor der ersten Gabe von HY reperfundiert.
Gruppe II erhielt intrakoronar 500 IU/kg. Danach wurde die LAD bei geschlossenem Thorac okkludiert. In der folgenden 24stündigen Okklusionsperiode wurde die Dosis von 200 IU/kg HY siebenmal in regelmäßigen Abständen injiziert.
In beiden Gruppen wurden durch HY weder der Kollateral- noch der normale Fluß verändert, ebenso blieben hämodynamische Parameter konstant. Trotzdem führte die Therapie in Gruppe I zu einer Verringerung der Infarktgröße von einer Nekrose von 29% des Perfusionsgebietes (Kontrolle) zu 14% nach HY. Nach 24stündiger kontinuierlicher Therapie hingegen unterschied sich die Infarktgröße nicht von einer Kontrolle.
HY konnte daher signifikant den Übergang von Ischämie zu Nekrose verzögern, aber nicht verhindern. Die Infarktgröße nach 24stündigem Verschluß war indifferent gegenüber einer Kontrollgruppe.
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Hofmann, M., Hofmann, M. & Schaper, W. Influence of hyaluronidase on infarct size following experimental coronary occlusion of short (90′) or long (24 hrs) duration. Basic Res Cardiol 75, 340–352 (1980). https://doi.org/10.1007/BF01907582
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DOI: https://doi.org/10.1007/BF01907582