Post H, Schulz R, Gres P, Heusch G
Abeteilung für Pathophysiologie, Zentrum für Innere Medizin des Universitätklinikums Essen, Germany.
Am J Physiol Heart Circ Physiol. 2001 Dec;281(6):H2392-7. doi: 10.1152/ajpheart.2001.281.6.H2392.
We tested whether or not endogenous nitric oxide (NO) attenuates beta-adrenergic inotropic responsiveness during normoperfusion or moderate myocardial ischemia. In 13 anesthetized pigs with a cannulated left anterior descending (LAD) coronary artery, the maximal contractile responses to intracoronary dobutamine and calcium were assessed during normoperfusion and at the end of a 90-min period of moderate ischemia (50% reduction in coronary arterial inflow) without (group 1, n = 6) and with (group 2, n = 7) prior inhibition of NO synthesis [30 mg/kg iv N(omega)-nitro-L-arginine (L-NNA)]. Contractile function was assessed by a regional work index (sonomicrometry, micromanometry, mm. mmHg). In groups 1 and 2 during normoperfusion, the maximal increase of the work index was greater with calcium than with dobutamine. At the end of ischemia in group 1, the baseline work index was decreased by approximately 50%, and the subsequent maximal increase of the work index with dobutamine, but not with calcium, was reduced compared with normoperfusion. In group 2 during normoperfusion, L-NNA did not alter the maximal increases of the work index with dobutamine or calcium. At the end of ischemia, the baseline work index was reduced by 64%, and the subsequent maximal increases of the work index with both dobutamine and calcium were reduced compared with normoperfusion; however, the response to calcium was still greater than that to dobutamine. We conclude that endogenous NO does not limit beta-adrenergic inotropic responsiveness in normoperfused or moderately ischemic porcine myocardium.
我们测试了内源性一氧化氮(NO)在正常灌注或中度心肌缺血期间是否会减弱β-肾上腺素能正性肌力反应。在13只左冠状动脉前降支(LAD)插管的麻醉猪中,在正常灌注期间以及在中度缺血(冠状动脉血流量减少50%)90分钟结束时,评估对冠状动脉内多巴酚丁胺和钙的最大收缩反应,其中一组(第1组,n = 6)未预先抑制NO合成,另一组(第2组,n = 7)预先抑制NO合成[静脉注射30 mg/kg N(ω)-硝基-L-精氨酸(L-NNA)]。通过区域作功指数(超声心动图、微测压法,mm·mmHg)评估收缩功能。在第1组和第2组的正常灌注期间,钙引起的作功指数最大增加幅度大于多巴酚丁胺。在第1组缺血结束时,基线作功指数下降约50%,与正常灌注相比,随后多巴酚丁胺引起的作功指数最大增加幅度降低,但钙引起的未降低。在第2组正常灌注期间,L-NNA未改变多巴酚丁胺或钙引起的作功指数最大增加幅度。在缺血结束时,基线作功指数降低了64%,与正常灌注相比,随后多巴酚丁胺和钙引起的作功指数最大增加幅度均降低;然而,对钙的反应仍大于对多巴酚丁胺的反应。我们得出结论,内源性NO不会限制正常灌注或中度缺血猪心肌中的β-肾上腺素能正性肌力反应。