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缺血后心肌收缩功能与氧化代谢之间的分离。再灌注期间给予钌红可减轻这种分离。

Dissociation between contractile function and oxidative metabolism in postischemic myocardium. Attenuation by ruthenium red administered during reperfusion.

作者信息

Benzi R H, Lerch R

机构信息

Cardiology Center, University Hospital, Geneva, Switzerland.

出版信息

Circ Res. 1992 Sep;71(3):567-76. doi: 10.1161/01.res.71.3.567.

Abstract

The oxidative metabolic rate may be disproportionately high compared with contractile function in postischemic reperfused myocardium. To study the potential involvement of intracellular calcium transport in high energy expenditure after reperfusion, we determined in isolated rat hearts the effect of ruthenium red, an inhibitor of mitochondrial calcium transport, on recovery of contractile function and oxidative metabolic rate. Hearts subjected to 60 minutes of no-flow ischemia exhibited, at 15 minutes after the onset of reperfusion, poor recovery of left ventricular pressure development to only 7% of the corresponding value measured in control hearts (p less than 0.01). However, myocardial oxygen consumption was recovered to 84% of control (p = NS). The ratio of isovolumic contractile performance (expressed as the product of heart rate and left ventricular pressure development) to myocardial oxygen consumption was severely depressed to 6% of control (p less than 0.01). Supplementation of the perfusate with 6 microM ruthenium red during the initial 40 minutes of reperfusion resulted in a reduction of myocardial oxygen consumption to 65% of the value measured after 15 minutes of reperfusion in hearts reperfused without ruthenium red (p less than 0.01), despite a threefold increase of left ventricular pressure development (p less than 0.05). Oxidation of both palmitate and glucose was reduced to a comparable extent by ruthenium red. The ratio of contractile performance to myocardial oxygen consumption increased progressively during infusion of ruthenium red and did not differ further from control hearts after 30 minutes of reperfusion. Cumulative myocardial release of creatine kinase was reduced by 47% (p less than 0.05) in hearts reperfused with ruthenium red-containing medium. The results provide circumstantial evidence for the hypothesis suggesting that enhanced energy expenditure by intracellular calcium transport may be involved in the mechanisms underlying the dissociation between left ventricular performance and myocardial oxidative metabolic rate early after postischemic reperfusion.

摘要

与缺血后再灌注心肌的收缩功能相比,其氧化代谢率可能过高。为了研究细胞内钙转运在再灌注后高能量消耗中的潜在作用,我们在离体大鼠心脏中测定了线粒体钙转运抑制剂钌红对收缩功能恢复和氧化代谢率的影响。经历60分钟无血流缺血的心脏,在再灌注开始后15分钟时,左心室压力发展的恢复较差,仅为对照心脏测量值的7%(p<0.01)。然而,心肌耗氧量恢复到对照值的84%(p=无显著性差异)。等容收缩性能(以心率与左心室压力发展的乘积表示)与心肌耗氧量的比值严重降低至对照值的6%(p<0.01)。在再灌注的最初40分钟内,向灌注液中添加6μM钌红,尽管左心室压力发展增加了三倍(p<0.05),但心肌耗氧量降至在无钌红再灌注的心脏中再灌注15分钟后测量值的65%(p<0.01)。钌红使棕榈酸和葡萄糖的氧化程度均有相当程度的降低。在输注钌红期间,收缩性能与心肌耗氧量的比值逐渐增加,再灌注30分钟后与对照心脏无进一步差异。用含钌红的培养基再灌注的心脏中,肌酸激酶的累积心肌释放量减少了47%(p<0.05)。这些结果为以下假设提供了间接证据,即细胞内钙转运导致的能量消耗增加可能参与了缺血后再灌注早期左心室功能与心肌氧化代谢率分离的潜在机制。

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