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急性输注生长激素对离体血液灌注心脏的冠状动脉血管、心肌功能及能量代谢影响的初步观察

Preliminary observations on the effects of acute infusion of growth hormone on coronary vasculature and on myocardial function and energetics of an isolated and blood-perfused heart.

作者信息

Lorusso R, Pasini E, Cargnoni A, Ceconi C, Volterrani M, Burattin A, Valle D, Ferrari R, Giustina A

机构信息

Experimental Cardiac Surgery Unit, Ospedale Civile, Brescia, Italy.

出版信息

J Endocrinol Invest. 2003 Jan;26(1):RC1-4. doi: 10.1007/BF03345113.

Abstract

Recent studies have shown that growth hormone (GH) deficiency may deteriorate post-ischemic myocardial reperfusion damage. Furthermore, GH has been reported to be a promising therapeutic option in the treatment of chronic myocardial dysfunction. However, the exact mechanisms of action of GH on the cardiovascular system, particularly in the acute setting, are still unclear. The aim of our study consisted of monitoring the acute effects of GH infusion on isolated blood-perfused rabbit heart according to dose-response pattern and during ischemic conditions to test its anti-ischemic property. Seven blood-donors perfused isolated hearts were used as experimental model. The mechanical and metabolic data of the isolated organs were continuously monitored. Under aerobic conditions, dose-response curves were initially tested after intracoronary infusion of GH at increasing dosages (1, 2, 3 mg/l). After a stabilization period, the effects of GH infusion (5 mg/kg) administered 30 minutes prior to acute global myocardial ischemia (30 minutes) were also investigated. At the doses tested, GH did not induce any changes either in the developed or in the diastolic pressures of the isolated organ. However, transient reduction of the coronary perfusion pressure was observed at the dosage of 3 mg/l. During the ischemia/reperfusion study, at the dosages used in this study, GH did not modify either the degree of stunning in the early reperfusion or the recovery of the developed pressure at the end of reperfusion. In addition, GH did not prevent either the increase of diastolic pressure during ischemia or the release of lactate and CPK during reperfusion. Tissue content of high-energy phosphates was also not changed by GH infusion. In our experimental model, acute GH infusion did not reduce the ischemic/reperfusion damage of the myocardium. However, GH transiently induced coronary vasodilation without modifying the myocardial contractility. Acute effects of GH appear, therefore, to predominantly relate to vascular dilation suggesting that the effects on myocardial contractility may require long-lasting intake being likely linked to enhancement of specific protein synthesis or gene expression of cardiac myocytes.

摘要

近期研究表明,生长激素(GH)缺乏可能会使缺血后心肌再灌注损伤恶化。此外,据报道,GH是治疗慢性心肌功能障碍的一种有前景的治疗选择。然而,GH对心血管系统的确切作用机制,尤其是在急性情况下,仍不清楚。我们研究的目的是根据剂量反应模式监测GH输注对离体血液灌注兔心脏的急性影响,并在缺血条件下测试其抗缺血特性。使用七只供血者的离体心脏作为实验模型。持续监测离体器官的机械和代谢数据。在有氧条件下,冠状动脉内输注递增剂量(1、2、3mg/l)的GH后,首先测试剂量反应曲线。在稳定期后,还研究了在急性全心缺血(30分钟)前30分钟给予GH输注(5mg/kg)的效果。在所测试的剂量下,GH对离体器官的收缩压或舒张压均未引起任何变化。然而,在3mg/l的剂量下观察到冠状动脉灌注压短暂降低。在缺血/再灌注研究中,在本研究使用的剂量下,GH既未改变早期再灌注时的心肌顿抑程度,也未改变再灌注结束时收缩压的恢复情况。此外,GH既未阻止缺血期间舒张压的升高,也未阻止再灌注期间乳酸和肌酸磷酸激酶的释放。高能磷酸盐的组织含量也未因GH输注而改变。在我们的实验模型中,急性GH输注并未减轻心肌的缺血/再灌注损伤。然而,GH短暂地诱导冠状动脉血管舒张,而未改变心肌收缩力。因此,GH的急性作用似乎主要与血管舒张有关,这表明对心肌收缩力的影响可能需要长期摄入,可能与心肌细胞特定蛋白质合成或基因表达的增强有关。

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