Guideri G, Barletta M, Chau R, Green M, Lehr D
Recent Adv Stud Cardiac Struct Metab. 1975;10:661-79.
In earlier reports from this laboratory, it was shown that 3 weeks' pretreatment with desoxycorticosterone acetate (DCA) pellet implantation and saline as drinking fluid caused a nearly 20,000-fold potentiation of the acute cardiotoxicity of isoproterenol. In such animals, the beta-receptor stimulant consistently elicited severe ventricular dysrhythmias, usually leading to ventricular fibrillation (VF) and death. In the present study, a similar enhancement of isoproterenol arrhythmogenic activity after DCA-saline pretreatment was demonstrated also in the guinea pig and albino mouse. It was found, further, that isoproterenol consistently caused an alteration of the total myocardial electrolyte content in DCA-saline-treated rats, consisting of a decrease of magnesium (Mg) and potassium (K) levels and elevation of sodium (Na). In control rats, on the other hand, isoproterenol did not alter the myocardial Mg content and increased K. The emertence of cardiac irregularities and VF could be inhibited by pretreatment with antiarrhythmic drugs. On a molar basis, these agents decreased the incidence of VF in the following descending order: dl-propranolol (100), practolol (39), d-propranolol (34), sotalol (20), quinidine (8), and lidocaine (5). In the presence of any of the listed drugs, except for lidocaine, isoproterenol did not lower Mg levels and had variable effects on those of Na and K. Pretreatment with Mg gluconate was likewise effective in preventing isoproterenol-induced dysrhythmias and death. These findings demonstrate that: a) sensitization of the myocardium by DCA-saline treatment is not species-specific for the rat; b) this phenomenon can be a useful method for the screening of antiarrhythmic drugs; and c) isoproterenol-induced dysrhythmias may be associated with myocardial electrolyte alterations involving especially Mg depletion.
在本实验室早期的报告中显示,用醋酸脱氧皮质酮(DCA)颗粒植入和生理盐水作为饮用水进行3周的预处理,可使异丙肾上腺素的急性心脏毒性增强近20000倍。在这类动物中,β受体兴奋剂始终会引发严重的室性心律失常,通常导致心室颤动(VF)和死亡。在本研究中,在豚鼠和白化小鼠中也证实了DCA - 生理盐水预处理后异丙肾上腺素致心律失常活性有类似增强。进一步发现,异丙肾上腺素始终会导致DCA - 生理盐水处理的大鼠心肌总电解质含量发生改变,包括镁(Mg)和钾(K)水平降低以及钠(Na)升高。另一方面,在对照大鼠中,异丙肾上腺素不会改变心肌Mg含量,而是使K增加。心律失常和VF的出现可通过抗心律失常药物预处理来抑制。以摩尔为基础,这些药物按以下降序降低VF的发生率:dl - 普萘洛尔(100)、普拉洛尔(39)、d - 普萘洛尔(34)、索他洛尔(20)、奎尼丁(8)和利多卡因(5)。在除利多卡因之外的任何一种所列药物存在的情况下,异丙肾上腺素不会降低Mg水平,并且对Na和K的水平有不同影响。用葡萄糖酸镁预处理同样有效地预防了异丙肾上腺素诱导的心律失常和死亡。这些发现表明:a)DCA - 生理盐水处理使心肌致敏并非大鼠特有的物种现象;b)这种现象可能是筛选抗心律失常药物的有用方法;c)异丙肾上腺素诱导的心律失常可能与特别是涉及Mg耗竭的心肌电解质改变有关。