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The nitric oxide donor S-nitroso-N-acetylpenicillamine (SNAP) increases free radical generation and degrades left ventricular function after myocardial ischemia-reperfusion
Journal article   Peer reviewed

The nitric oxide donor S-nitroso-N-acetylpenicillamine (SNAP) increases free radical generation and degrades left ventricular function after myocardial ischemia-reperfusion

Yi Zhang, Loyd R DAVIES, Sean M MARTIN, William J CODDINGTON, Francis J MILLER, Garry R BUETTNER and Richard E KERBER
Resuscitation, Vol.59(3), pp.345-352
2003
DOI: 10.1016/S0300-9572(03)00240-5
PMCID: PMC4343200
PMID: 14659604

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Abstract

Background: During reperfusion of ischemic myocardium nitric oxide (NO) reacts with superoxide radicals to form cardiotoxic peroxynitrite, which causes lipid peroxidation. Our hypothesis was that infusion of a NO donor S-nitroso-N-acetylpenicillamine (SNAP) during ischemia–reperfusion would exacerbate the oxidative damage to the myocardium by increased formation of nitrogen radicals. Methods and results: In 19 open-chest dogs, left anterior descending (LAD) coronary occlusion (15 min)–reperfusion (15 min) sequences were created. Using electron paramagnetic resonance (EPR), we monitored the coronary sinus concentration of ascorbate free radical (Asc−), a measure of free radical generation (total oxidative flux). Seven control dogs (Group 1) received intravenous saline infusion during occlusion–reperfusion, while 12 dogs received SNAP infusion (Group 2: 2.5 μg/min per kg SNAP, and Group 3: 5 μg/min per kg SNAP). Left ventricular fractional area shortening was determined by echocardiography. Dogs in Group 3 receiving a high dose of SNAP (5 μg/min per kg) demonstrated a higher Asc− concentration increase than the control group. Percent fractional area shortening in Group 1 declined from 77±4.0 (baseline) to 54±9.0% during ischemia (P<0.05), and then fully recovered to 74±3.7% with reperfusion. In the SNAP-treated dogs, the percent fractional area shortening during reperfusion was significantly lower than baseline in Group 2 (55±3.9 vs. baseline 74±4.4%, P<0.05) and in Group 3 (49±5.0 vs. baseline 71±4.5%, P<0.01). In five additional dogs, nitrotyrosine immunohistochemistry showed heavy staining of the ischemic-reperfused myocardium. Conclusions: The NO donor SNAP increased free radical concentration and exacerbated myocardial oxidative damage after ischemia–reperfusion.
Biological and medical sciences Intensive care medicine Medical sciences Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy

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