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大鼠心肌梗死后的充血性心力衰竭:心脏收缩力与自发肌节活动

Congestive heart failure after myocardial infarction in the rat: cardiac force and spontaneous sarcomere activity.

作者信息

Davidoff A W, Boyden P A, Schwartz K, Michel J B, Zhang Y M, Obayashi M, Crabbe D, ter Keurs H E D J

机构信息

Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1 Canada.

出版信息

Ann N Y Acad Sci. 2004 May;1015:84-95. doi: 10.1196/annals.1302.007.

Abstract

The causes of reduced cardiac force development in congestive heart failure (CHF) are still uncertain. We explored the subcellular mechanisms leading to decreased force development in trabeculae from rats with a myocardial infarction. We defined CHF according to clinical and pathological criteria and compared properties of trabeculae from animals with CHF (cMI) to those of animals with a myocardial scar but without evidence of CHF (uMI), and sham-operated animals. The new findings of this study on properties of cMI trabeculae are that (1) maximal twitch force following post-extrasystolic potentiation is unchanged; (2) the sensitivity of cMI trabeculae to Ca(2+) is increased; (3) spontaneous diastolic sarcomere length (SL) fluctuations (SA) are increased in cMI at all levels of SR Ca(2+) loading; and (4) SA is accompanied by a proportional reduction of F(max). The results suggest that the probability of spontaneous diastolic opening of SR Ca(2+) channels is increased in CHF. These data provide the basis for a novel mechanism underlying systolic and diastolic dysfunction as well as arrhythmias in hearts in CHF. If SA proves to be a component of myocardial dysfunction in human CHF, our thinking about therapy of the patient with CHF may be profoundly changed.

摘要

充血性心力衰竭(CHF)中心肌收缩力降低的原因仍不明确。我们探究了心肌梗死大鼠小梁中导致收缩力降低的亚细胞机制。我们根据临床和病理标准定义CHF,并比较了CHF动物(cMI)、有心肌瘢痕但无CHF证据的动物(uMI)以及假手术动物的小梁特性。本研究关于cMI小梁特性的新发现是:(1)期外收缩后增强后的最大抽搐力未改变;(2)cMI小梁对Ca(2+)的敏感性增加;(3)在所有肌浆网Ca(2+)负荷水平下,cMI中的自发性舒张期肌节长度(SL)波动(SA)均增加;(4)SA伴随着F(max)成比例降低。结果表明,CHF时肌浆网Ca(2+)通道自发性舒张期开放的概率增加。这些数据为CHF心脏收缩和舒张功能障碍以及心律失常的新机制提供了依据。如果SA被证明是人类CHF中心肌功能障碍的一个组成部分,我们对CHF患者治疗的看法可能会发生深刻改变。

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