Davidoff A W, Boyden P A, Schwartz K, Michel J B, Zhang Y M, Obayashi M, Crabbe D, ter Keurs H E D J
Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1 Canada.
Ann N Y Acad Sci. 2004 May;1015:84-95. doi: 10.1196/annals.1302.007.
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.
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。