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生长激素的抗心律失常作用——来自急性心肌梗死小动物模型和侵入性电生理学的体内证据

Antiarrhythmic effects of growth hormone--in vivo evidence from small-animal models of acute myocardial infarction and invasive electrophysiology.

作者信息

Råmunddal Truls, Gizurarson Sigfus, Lorentzon Malin, Omerovic Elmir

机构信息

The Wallenberg Laboratory for Cardiovascular Research at Sahlgrenska Academy, Gothenburg, Sweden.

出版信息

J Electrocardiol. 2008 Mar-Apr;41(2):144-51. doi: 10.1016/j.jelectrocard.2007.09.002.

Abstract

INTRODUCTION

A growing body of evidence suggests a possible role for growth hormone (GH) in the treatment of congestive heart failure (CHF) and myocardial infarction (MI). The aim of this study was to investigate in vivo the effects of GH treatment on incidence and severity of ventricular arrhythmias normal and MI rats.

METHODS

Male Sprague-Dawley rats weighing approximately 350 g were randomized into 3 groups. Growth hormone-treated rats (n = 6) received 6 mg/kg of human GH. The placebo group (n = 10) received 1 mL of saline. Amiodarone-treated rats (n = 10) were injected with 25 mg/kg and served as positive controls. All animals received a single intraperitoneal injection 6 hours before induction of MI. Myocardial infarction was induced by ligation of the left coronary artery, resulting in a large (approximately 40%) anterolateral MI. A computerized electrocardiographic tracing was obtained continuously before induction of MI and up to 1 hour postinfarction. Invasive hemodynamics including intraventricular and arterial pressure were registered for 60 minutes post-MI. Qualitative as well as quantitative variables of ventricular arrhythmias were analyzed. Invasive electrophysiology with pacing in right atrium and ventricle was performed in normal rats (control, n = 13; GH, n = 6; amiodarone, n = 6) to asses inducibility of supraventricular and ventricular arrhythmias.

RESULTS

Growth hormone- and amiodarone-treated rats had lower resting heart rate at baseline before induction of MI. The arrhythmia scores in the GH- (3.8 +/- 1) and amiodarone-treated (3.9 +/- 0.5) animals were significant lower than in the placebo group (5.9 +/- 0.5, P < .05). There was no significant difference in arrhythmia score between the GH and amiodarone groups. The incident of inducible ventricular arrhythmias was lower in the GH (2/6, 33%) and amiodarone (2/6, 33%) groups compared with controls (13/16, 81%; P = .05). There was no difference in inducibility of atrial fibrillation between the GH (5/6, 83%) and control (13/14, 93%) groups, whereas the inducibility of atrial fibrillation was significantly lower in the amiodarone group (2/6, 33%; P < .05).

CONCLUSIONS

Pretreatment with GH reduces the burden of ventricular arrhythmias in rats with postinfarction CHF due to acute MI. Growth hormone may be useful in the treatment of CHF and acute MI.

摘要

引言

越来越多的证据表明生长激素(GH)在治疗充血性心力衰竭(CHF)和心肌梗死(MI)中可能发挥作用。本研究的目的是在体内研究GH治疗对正常大鼠和MI大鼠室性心律失常的发生率和严重程度的影响。

方法

将体重约350 g的雄性Sprague-Dawley大鼠随机分为3组。生长激素治疗组(n = 6)接受6 mg/kg的人GH。安慰剂组(n = 10)接受1 mL生理盐水。胺碘酮治疗组(n = 10)注射25 mg/kg并作为阳性对照。所有动物在诱导MI前6小时接受单次腹腔注射。通过结扎左冠状动脉诱导心肌梗死,导致大面积(约40%)前外侧MI。在诱导MI前及梗死发生后1小时内持续进行计算机化心电图描记。在MI后60分钟记录包括心室内压和动脉压在内的有创血流动力学。分析室性心律失常的定性和定量变量。对正常大鼠(对照组,n = 13;GH组,n = 6;胺碘酮组,n = 6)进行右心房和心室起搏的有创电生理检查,以评估室上性和室性心律失常的诱发性。

结果

生长激素和胺碘酮治疗组大鼠在诱导MI前基线时静息心率较低。GH治疗组(3.8±1)和胺碘酮治疗组(3.9±0.5)动物的心律失常评分显著低于安慰剂组(5.9±0.5,P <.05)。GH组和胺碘酮组之间的心律失常评分无显著差异。与对照组(13/16,81%;P =. |05)相比,GH组(|2/6,33%)和胺碘酮组(2/6,33%)可诱导室性心律失常的发生率较低。GH组(5/6,83%)和对照组(13/14,93%)之间房颤的诱发性无差异,而胺碘酮组房颤的诱发性显著较低(2/6,33%;P <.05)。

结论

GH预处理可减轻急性MI所致梗死后CHF大鼠的室性心律失常负担。生长激素可能对CHF和急性MI的治疗有用。

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