Fontana M, Olschewski H, Olschewski A, Schlüter K-D
Physiologisches Institut, Justus-Liebig-Universität, Giessen, Germany.
Br J Pharmacol. 2007 Jul;151(6):779-86. doi: 10.1038/sj.bjp.0707300. Epub 2007 May 29.
Prostanoids have been shown to improve exercise tolerance, hemodynamics and quality of life in patients with pulmonary arterial hypertension (PAH). We investigated whether treprostinil exerts direct contractile effects on cardiomyocytes that may explain partly the beneficial effects of these drugs.
Ventricular cardiomyocytes from adult rats were paced at a constant frequency of 0.5 to 2.0 Hz and cell shortening was monitored via a cell edge detection system. Twitch amplitudes, expressed as percent cell shortening of the diastolic cell length, and maximal contraction velocity, relaxation velocity, time to peak of contraction and time to reach 50% of relaxation were analyzed.
Treprostinil (0.15 - 15 ng ml(-1)) slightly increased contractile dynamics of cardiomyocytes at clinically relevant concentrations. However, the drug significantly improved cell shortening of cardiomyocytes in the presence of isoprenaline, a beta-adrenoceptor agonist. Treprostinil exerted this effect at all beating frequencies under investigation. Treprostinil mimicked this potentiating effect in a Langendorff preparation as well. The potentiating effect of treprostinil on isoprenaline-dependent cell shortening was no longer seen after phosphodiesterase inhibition. Long-term cultivation of cardiomyocytes with treprostinil did not modify load free cell shortening of these cells, but reduces the duration of contraction.
We conclude that the clinically used prostanoid treprostinil potentiates the positive inotropic effects of catecholamines in adult ventricular cardiomyocytes. This newly described effect may contribute to the beneficial clinical effects of prostanoids in patients with PAH.
前列环素已被证明可改善肺动脉高压(PAH)患者的运动耐量、血流动力学和生活质量。我们研究了曲前列尼尔是否对心肌细胞产生直接收缩作用,这可能部分解释了这些药物的有益效果。
以0.5至2.0 Hz的恒定频率对成年大鼠的心室心肌细胞进行起搏,并通过细胞边缘检测系统监测细胞缩短情况。分析了以舒张期细胞长度的细胞缩短百分比表示的单次收缩幅度,以及最大收缩速度、舒张速度、收缩峰值时间和达到50%舒张时间。
在临床相关浓度下,曲前列尼尔(0.15 - 15 ng ml(-1))略微增加了心肌细胞的收缩动力学。然而,在存在β - 肾上腺素能受体激动剂异丙肾上腺素的情况下,该药物显著改善了心肌细胞的缩短。曲前列尼尔在所有研究的起搏频率下均发挥此作用。曲前列尼尔在Langendorff标本中也模拟了这种增强作用。磷酸二酯酶抑制后,曲前列尼尔对异丙肾上腺素依赖性细胞缩短的增强作用不再出现。用曲前列尼尔长期培养心肌细胞并未改变这些细胞的无负荷细胞缩短,但缩短了收缩持续时间。
我们得出结论,临床使用的前列环素曲前列尼尔增强了成年心室心肌细胞中儿茶酚胺的正性肌力作用。这种新描述的作用可能有助于前列环素对PAH患者的有益临床效果。