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完整心脏在体内除颤强度电击期间的膜时间常数:Na+和Ca2+通道阻滞剂的作用。

Membrane time constant during internal defibrillation strength shocks in intact heart: effects of Na+ and Ca2+ channel blockers.

作者信息

Mowrey Kent A, Efimov Igor R, Cheng Yuanna

机构信息

Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA.

出版信息

J Cardiovasc Electrophysiol. 2009 Jan;20(1):85-92. doi: 10.1111/j.1540-8167.2008.01273.x. Epub 2008 Sep 3.

Abstract

INTRODUCTION

We assessed defibrillation strength shock-induced changes of the membrane time constant (tau) and membrane potential (DeltaVm) in intact rabbit hearts after administration of lidocaine, a sodium (Na(+)) channel blocker, or nifedipine, a L-type calcium (Ca(2+)) channel blocker.

METHODS AND RESULTS

We optically mapped anterior, epicardial, electrical activity during monophasic shocks (+/-100, +/-130, +/-160, +/-190, and +/-220 V; 150 microF; 8 ms) applied at 25%, 50%, and 75% of the action potential duration via a shock lead system in Langendorff-perfused hearts. The protocol was run twice for each heart under control and after lidocaine (15 microM, n = 6) or nifedipine (2 microM, n = 6) addition. tau in the virtual electrode area away from the shock lead was approximated with single-exponential fits from a total of 121,125 recordings. The same data set was used to calculate DeltaVm. We found (1) Under all conditions, there is inverse relationship between tau and DeltaVm with respect to changes of shock strength, regardless of shock polarity and phase of application: a stronger shock resulted in a larger DeltaVm, which corresponded to a smaller tau (faster cellular response); (2) Lidocaine did not cause appreciable changes in either tau or DeltaVm versus control, and (3) Nifedipine significantly increased both tau and DeltaVm in the virtual cathode area; in contrast, in the virtual anode area, this effect depended on the phase of shock application.

CONCLUSION

tau and DeltaVm are inversely related. Na(+) channel blocker has minimal impact on either tau or DeltaVm. Ca(2+) blocker caused polarity and phase-dependent significant changes in tau and DeltaVm.

摘要

引言

我们评估了利多卡因(一种钠(Na⁺)通道阻滞剂)或硝苯地平(一种L型钙(Ca²⁺)通道阻滞剂)给药后,完整兔心脏中除颤强度电击诱导的膜时间常数(tau)和膜电位(ΔVm)的变化。

方法与结果

我们通过Langendorff灌注心脏中的电击导联系统,在动作电位持续时间的25%、50%和75%时施加单相电击(±100、±130、±160、±190和±220 V;150 μF;8 ms),光学映射前壁心外膜电活动。在对照条件下以及添加利多卡因(15 μM,n = 6)或硝苯地平(2 μM,n = 6)后,对每颗心脏重复该方案两次。远离电击导联的虚拟电极区域中的tau通过对总共121,125次记录进行单指数拟合来近似。使用相同的数据集计算ΔVm。我们发现:(1)在所有条件下,无论电击极性和施加阶段如何,tau和ΔVm在电击强度变化方面呈反比关系:更强的电击导致更大的ΔVm,这对应于更小的tau(更快的细胞反应);(2)与对照相比,利多卡因对tau或ΔVm均未引起明显变化;(3)硝苯地平显著增加了虚拟阴极区域中的tau和ΔVm;相反,在虚拟阳极区域,这种效应取决于电击施加阶段。

结论

tau和ΔVm呈反比关系。Na⁺通道阻滞剂对tau或ΔVm的影响最小。Ca²⁺阻滞剂导致tau和ΔVm出现极性和阶段依赖性的显著变化。

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