Larsen T S, Belke D D, Sas R, Giles W R, Severson D L, Lopaschuk G D, Tyberg J V
Department of Physiology and Biophysics, University of Calgary, Faculty of Medicine, Calgary, Alberta, Canada T2N 4N1.
Pflugers Arch. 1999 May;437(6):979-85. doi: 10.1007/s004240050870.
Our aim was to develop a working isolated murine heart model, as the extensive use of genetically engineered mice in cardiovascular research requires development of new miniaturized technology. Left ventricular (LV) function was assessed in the isolated working mouse heart perfused with recirculated oxygenated Krebs-Henseleit bicarbonate buffer (37 degrees C pH 7.4) containing 11.1 mM glucose and 0.4 mM palmitate bound to 3% albumin. The hearts worked against an afterload reservoir at a height equivalent to 50 mmHg, and heart rate was controlled by electrical pacing of the right atrium. LV pressure was measured with a micromanometer connected to a small steel cannula inserted through the apex of the heart. The experimental protocol consisted of two interventions. First, following instrumentation and stabilization, the preload reservoir was raised from a pressure equivalent of 7 to 22.5 mmHg, while pacing at 390 beats.min-1. Thereafter the height of the preload reservoir was set to 10 mmHg, and the pacing rate was varied from 260 to 600 beats.min-1. Aortic and coronary flows were measured by timed collections of effluent from the afterload line and that dripping from the heart, respectively [aortic+coronary flow=cardiac output (CO)]. Elevation of LV end-diastolic pressure (LVEDP) from approximately 5 to 10 mmHg resulted in a twofold increase in average cardiac power [product of LV developed pressure (LVDevP) and CO], whereas myocardial contractility (first derivative of LV pressure, dP/dt) and LVDevP (LV systolic pressure-LVEDP) increased only minimally (5-10%). Measured LVEDP was lower than the equivalent height of the preload reservoir by an amount that was related to the heart rate. Cardiac power, LVDevP and dP/dt were stable at heart rates up to 400 beats.min-1, but declined markedly with higher rates, consistent with the decrease in LVEDP. Thus, cardiac power was reduced to 50% of its maximum value when stimulated at approximately 500 beats.min-1, and at even higher rates there was little ejection. By systematic manipulation of the height of the preload reservoir and heart rate, we conclude that LV afterload and preload can be assessed only by high-fidelity measurement of intraventricular pressures. The heights of the afterload column and the preload reservoir are unreliable and potentially misleading indicators of LV afterload and preload.
我们的目标是开发一种实用的离体小鼠心脏模型,因为在心血管研究中广泛使用基因工程小鼠需要开发新的小型化技术。在灌注含有11.1 mM葡萄糖和与3%白蛋白结合的0.4 mM棕榈酸酯的再循环含氧Krebs-Henseleit碳酸氢盐缓冲液(37℃,pH 7.4)的离体工作小鼠心脏中评估左心室(LV)功能。心脏在相当于50 mmHg高度的后负荷储液器上工作,心率通过右心房的电起搏来控制。用连接到通过心脏心尖插入的小钢套管的微压计测量左心室压力。实验方案包括两项干预措施。首先,在仪器安装和稳定后,将前负荷储液器的压力从相当于7 mmHg提高到22.5 mmHg,同时以390次/分钟的频率起搏。此后,将前负荷储液器的高度设置为10 mmHg,并将起搏频率从260次/分钟变化到600次/分钟。分别通过定时收集后负荷管路的流出液和从心脏滴下的液体来测量主动脉和冠状动脉血流量[主动脉血流量+冠状动脉血流量=心输出量(CO)]。左心室舒张末期压力(LVEDP)从约5 mmHg升高到10 mmHg导致平均心脏功率(左心室发育压力(LVDevP)与CO的乘积)增加两倍,而心肌收缩力(左心室压力的一阶导数,dP/dt)和LVDevP(左心室收缩压-LVEDP)仅略有增加(5-10%)。测量的LVEDP比前负荷储液器的等效高度低一定量,该量与心率有关。心脏功率、LVDevP和dP/dt在心率高达400次/分钟时稳定,但随着心率升高而显著下降,这与LVEDP的降低一致。因此,当以约500次/分钟的频率刺激时,心脏功率降至其最大值的50%,而在更高频率时几乎没有射血。通过系统地操纵前负荷储液器的高度和心率,我们得出结论,只有通过高保真测量心室内压力才能评估左心室后负荷和前负荷。后负荷柱和前负荷储液器的高度是左心室后负荷和前负荷不可靠且可能产生误导的指标。